Incorporating ‘off-the-shelf’ reconstruction plates into the digital plan for mandible reconstruction

Authors

• Kai Cheng , Jonathan R. Clark Royal Prince Alfred Hospital, Institute of Academic Surgery, Sydney Local Health District; Sydney, Australia
• David Leinkram, Jonathan R. Clark Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O’Brien Lifehouse,Sydney, Australia
• Dale Howes Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
• Jonathan R. Clark Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

Abstract

This short communication describes the process to incorporate non-custom fixation plates into the digital workflow for in-house virtual surgical planning and proposes solutions to improve surgical precision when executing the digital plan. A custom-made two-stage digital pin positioning and alignment system was built to articulate the screw channels by matching the digital pins to the scan. The location and angle of each digital pin is then translated into the design of the mandible and fibula cutting guides. This protocol overcomes some of the inherent disadvantages of not being able to print or mill a patient-specific plate.