Enhanced accuracy of cutting planes and condylar positioning in mandibular reconstruction using three-dimensional-printed guides: An in vitro study.

BACKGROUND/PURPOSE: Accurate mandibular reconstruction, particularly condylar repositioning, is essential for restoring function and facial symmetry following segmental resection. This study aimed to evaluate the accuracy of cutting planes and three-dimensional (3D) condylar positioning using 3D-printed cutting guides combined with plate-guided positioning. MATERIALS AND METHODS: This in vitro study included sixteen 3D-printed mandibular models simulating segmental defects. Virtual surgical planning was employed to fabricate 3D-printed cutting guides and plate-guided positioning. Postoperative models were compared with their corresponding virtual models using 3-Matic software to assess cutting plane and 3D condylar positioning deviations. RESULTS: The angular deviations of the proximal cutting plane averaged 13.27 ± 10.36 mm in pitch and 12.1 ± 8.67 mm in yaw, demonstrating acceptable alignment. The mean difference in defect distance was 0.51 ± 3.53 mm (P = 0.93). Intercondylar angulation deviation was 2.13 ± 2.53°, with no significant difference in intercondylar distance (100.75 ± 7.32 mm vs. 102.01 ± 6.99 mm, P = 0.51). On the operative side, deviations of the highest points of the condyle were 2.76 ± 3.39 mm (superior-inferior), 2.37 ± 2.76 mm (anterior-posterior), and 1.94 ± 2.93 mm (medial-lateral). Angular deviations of the condylar head axis were minimal in the coronal (1.66 ± 1.38°) and transverse (1.52 ± 1.51°) planes, as opposed to the sagittal plane (5.61 ± 5.26°). CONCLUSION: 3D-printed cutting guides and plate-guided positioning allowed for accurate replication of virtual surgical plans in mandibular reconstruction. All deviations remained within acceptable limits. Further research is recommended to validate these findings.