Mandibular alveolar reconstruction using three-dimensional planning.

PURPOSE OF REVIEW: Resection of malignant disease often results in full-thickness segmental defects of the mandible and loss of dentition. Ideal rehabilitation of the patient requires replacement of the missing segment with vascularized bone that will receive dental implants, and allow osseointegrated prosthetic rehabilitation and restoration of dentition and proper occlusion. Inexact contouring of the bony reconstruction can result in both cosmetic and functional defects that can diminish the future quality of life of the patient. This review summarizes recent advances in preoperative planning and intraoperative techniques that can maximize the success of proper alveolar reconstruction and dental restoration of the patient suffering a segmental maxillary or mandibular defect. RECENT FINDINGS: Preoperative modeling can be achieved with computer software that utilizes patient imaging. From this imaging, anticipated surgical defects can be planned, models can be generated, and intraoperative templates can be produced. These can be used to improve reconstructive plate bending, relative positioning of bone to opposing jaw, contouring of the reconstructive bone, and even placement of osseointegrated implants in a single operative setting. SUMMARY: In patients with complex mandibular defects, the use of computer-assisted three-dimensional planning and modeling can result in time-saving and improved outcomes during maxillary and mandibular reconstruction.