Evidence map›Paper›PMID 40136621›Full record

ArticleDiseases (Basel, Switzerland)2025

Evaluating Osteotomy Accuracy in Mandibular Reconstruction: A Preliminary Study Using Custom Cutting Guides and Virtual Reality.

Claudia Borbon, Andrea Novaresio, Oreste Iocca, Francesca Nonis, Sandro Moos, Enrico Vezzetti, Guglielmo Ramieri, Emanuele Zavattero

Abstract read
In one paragraph

Article in Diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Claudia BorbonDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.
Andrea NovaresioDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.
Oreste IoccaDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.ORCID 0000-0002-4444-248X
Francesca NonisDepartment of Management and Production Engineering, Politecnico di Torino, 10129 Torino, Italy.ORCID 0000-0002-7332-7894
Sandro MoosDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.ORCID 0000-0001-5097-7344
Enrico VezzettiDepartment of Management and Production Engineering, Politecnico di Torino, 10129 Torino, Italy.
Guglielmo RamieriDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.ORCID 0000-0002-3131-9669
Emanuele ZavatteroDivision of Maxillofacial Surgery, Città della Salute e della Scienza University Hospital, 10126 Torino, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMandibular reconstruction has evolved significantly since its inception in the early 1900s. Currently, the fibula free flap (FFF) is considered the gold standard for mandibular and maxillary reconstructions, particularly for extensive defects, and the introduction of Extended Reality (XR) and virtual surgical planning (VSP) is revolutionizing maxillofacial surgery.

methodsThis study focuses on evaluating the accuracy of using in-house cutting guides for mandibular reconstruction with FFF supported by virtual surgical planning (VSP). Planned and intraoperative osteotomies obtained from postoperative CT scans were compared in 17 patients who met the inclusion criteria. The proposed analysis included measurements of deviation angles, thickness at the centre of gravity, and the maximum thickness of the deviation volume. Additionally, a mandibular resection coding including 12 configurations was defined to classify and analyze the precision of mandibular osteotomies and investigate systematic errors. Preoperative, planned, and postoperative models have been inserted in an interactive VR environment, VieweR, to enhance surgical planning and outcome analysis.

resultsThe results proved the efficiency of adopting customized cutting guides and highlighted the critical role of advanced technologies such as CAD/CAM and VR in modern maxillofacial surgery. A novel coding system including 12 possible configurations was developed to classify and analyze the precision of mandibular osteotomies. This system considers (1) the position of the cutting blade relative to the cutting plane of the mandibular guide; (2) the position of the intersection axis between the planned and intraoperative osteotomy relative to the mandible; (3) the direction of rotation of the intraoperative osteotomy plane around the intersection axis from the upper view of the model.

conclusionsThis study demonstrates the accuracy and reliability of in-house cutting guides for mandibular reconstruction using fibula free flaps (FFF) supported by virtual surgical planning (VSP). The comparison between planned and intraoperative osteotomies confirmed the precision of this approach, with minimal deviations observed. These findings highlight the critical role of CAD/CAM and XR technologies in modern maxillofacial surgery, offering improved surgical precision and optimizing patient outcomes.

Indexed as

fibula free flapmaxillofacial surgeryvirtual realityvirtual surgical planningVRVSP

Identifiers

PMID40136621
PMCPMC11941236

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.