BACKGROUND: The recent increase in computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted surgery has warranted a thorough evaluation of the accuracy of virtual plan execution. Mandibular reconstructions with a fibula free flap were evaluated by comparing the fibular segments postoperatively with the virtual surgical plans. METHODS: This study included computed tomography data for 20 patients (11 males; mean age 61.3 years, range 47-74) that received a mandibular reconstruction with a fibula free flap. Linear distances (superior and inferior borders) of 41 fibula segments and intercoronoid distances were measured. RESULTS: The mean difference was 3.11 +/- 2.80 mm for superior borders (range 0.02-12.20 mm), and 2.75 +/- 2.61 mm for inferior borders (range 0.22-13.58 mm). The mean intercoronoid difference was 3.57 +/- 1.80 mm (range 0.91-6.11 mm). CONCLUSION: This study confirmed the presumed accuracy regarding the use of fibular and mandibular cutting guides. CAD/CAM is an attractive technique which enhances efficiency and assurance during surgery and preoperative planning.
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