Reconstruction of the mandible using CAD/CAM technologies in patients with oral cancer and primary bone tumors
Summary. Mandibular reconstruction following segmental resection in patients with malignant neoplasms is a challenging task requiring consideration of functional, anatomical, and aesthetic factors. Objective. To evaluate the effectiveness of CAD/CAM technologies in mandibular reconstruction using fibular flaps in patients with oral cancer and primary bone tumors. Materials and methods. The study analyzed the treatment outcomes of 32 patients with locally advanced squamous cell carcinoma of the oral cavity and primary bone tumors, who underwent mandibular segmental defect reconstruction using fibular flaps and CAD/CAM technologies. Results. Total loss of the fibular flap was observed in 1 (3.1%) patient. Complete necrosis of the skin paddle occurred in 1 (3.1%) patient, partial necrosis in 3 (9.3%), and marginal necrosis in 2 (6.2%) cases. The reconstruction success rate was 96.9%. Oral feeding was restored in all 32 (100%) patients: 64% achieved level 5, and 36% achieved level 7 on the Functional Oral Intake Scale (FOIS). Minimal additional correction (>2 mm) of fibular bone segments was performed in 27 (84.3%) patients to optimize flap fit with preserved mandibular fragments and to fully restore the anatomical shape of the mandible. Conclusions. The use of CAD/CAM technologies for mandibular segmental defect reconstruction with fibular flaps ensures high precision, minimal postoperative complications, and reduced operative time.
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