ArticleFrontiers in oncology2021
The Learning Curve of Computer-Assisted Free Flap Jaw Reconstruction Surgery Using 3D-Printed Patient-Specific Plates: A Cumulative Sum Analysis.
Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 15 citations in OpenAlex.
- Experience with patient-specific guides, insteatientad of general surgical experience, improves the accuracy of 3D-guided corrective osteotomies.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Application of temporary patient-specific plate in head and neck osteocutaneous free flap reconstruction: a prospective pilot study.Frontiers in oral health · 2026Article
- Evaluation of dental students' learning curve in intraligamentary anesthesia using different syringe systems: A prospective crossover study.Journal of dental education · 2025Article
- Impact of introducing 3D printing-assisted surgery into clinical practice for traumatic pelvic and acetabular fractures.Journal of orthopaedics · 2024Article
- Effect of segmental versus marginal mandibular resection on local and lymph node recurrences in oral squamous cell carcinoma: is tumorous bone infiltration or location and resulting soft tissue recurrences a long-term problem?Journal of cancer research and clinical oncology · 2023Article
- Costs and duration of orthodontic-surgical treatment with mandibular advancement surgery.European journal of orthodontics · 2023Article
- Current Trends in the Reconstruction and Rehabilitation of Jaw following Ablative Surgery.Cancers · 2022Review
- Superficial Temporal Artery and Vein as Alternative Recipient Vessels for Intraoral Reconstruction With Free Flaps to Avoid the Cervical Approach With the Resulting Need for Double Flap Transfer in Previously Treated Necks.Frontiers in oncology · 2022Article
- Value of 3D printing technology combined with indocyanine green fluorescent navigation in complex laparoscopic hepatectomy.PloS one · 2022Article
- Surgical Margins After Computer-Assisted Mandibular Reconstruction: A Retrospective Study.Frontiers in oral health · 2021Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundComputer-assisted jaw reconstruction (CAJR) has benefits in reducing operation time and improving reconstruction accuracy, compared to conventional freehand jaw reconstruction. However, no information is available regarding learning curves in CAJR with the use of 3D-printed patient-specific surgical plates (PSSP). The purpose of this study was to assess surgical outcomes and learning curve for the first 58 consecutive CAJR using 3D-printed PSSP performed by a single surgical team in a single institution.
methodsIn a prospective study, consecutive patients who underwent free flap CAJR using 3D-printed PSSP were included. The determination of proficiency, based on the cumulative sum of surgical success (no major adjustment of 3D-printed PSSP, flap survival) passing the acceptable boundary line of cumulative sum analysis, was the primary outcome. To find out any potential factors influencing the learning curve, baseline characteristics of patients were compared before and after proficiency achievement. Secondary outcomes included inflexion points of the total operation time, blood loss, length of hospital stay, and bone graft deviation, measured by the cumulative sum analysis.
resultsFrom December 2016 to November 2020, 58 consecutive cases underwent surgery performed by a single surgical team. The overall surgical success rate was 94.8% (55/58). A three-stage learning curve of primary outcome was observed. The proficiency was achieved after 23 cases. The proportions of advanced tumor staging and concomitant surgery after obtaining proficiency were significantly higher than those before achieving proficiency (
conclusionOur results revealed a three-stage learning curve of CAJR with the use of PSSP, including initial learning, plateau, and overlearning. Based on CUSUM analysis, the surgical proficiency was achieved after 23 cases, and total operation time, length of hospital stay, and bone graft deviation stabilized after 8-17 cases.
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