Evidence map›Paper›PMID 41634287›Full record

ArticleOral and maxillofacial surgery2026

Accuracy of CAD/CAM planned mandibular reconstruction with scapula free flaps in reconstructive head and neck surgery - A single center study.

Jonas Wüster, Max Brandenburg, Tim Lukas Elter, Norbert Neckel, Jakob Fenske, Christian Doll, Carsten Rendenbach, Max Heiland, Claudius Steffen, Kilian Kreutzer and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Oral and maxillofacial surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 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

11 authors.

Jonas WüsterDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, University Medical Center Freiburg, Albert Ludwig University of Freiburg, Baden- Württemberg, Germany. jonas.wuester@uniklinik-freiburg.de.
Max BrandenburgDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Tim Lukas ElterDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Norbert NeckelDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Jakob FenskeDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Christian DollDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Carsten RendenbachDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Claudius SteffenDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Kilian Kreutzer *Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Steffen Koerdt *Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFor the first time, this study explores the transfer precision of computer aided design and computer aided manufacturing (CAD/CAM) in mandibular reconstruction with scapula free flaps (SFF).

methodsPatients undergoing mandibular reconstruction with SFF and patient-specific 3D-printed titanium plates were retrospectively analyzed. To assess planning accuracy, pre- and postoperative datasets were overlaid using 3D Slicer software. Specific measurements included the fit at the mandibular resection site, intersegmental gap width between scapula and mandible, scapular segment positioning, and condylar alignment. Osseous union was evaluated via postoperative computed tomography (CT) or cone beam CT, and plate-related complications were recorded clinically.

resultsIn total 15 patients (mean age 65.7 ± 10.0 years) were included. Postoperative scapular segment positioning showed deviations in the posterior region (basal: 6.78 ± 3.34 mm; crestal: 7.61 ± 3.40 mm) and anterior region (basal: 3.54 ± 1.52 mm; crestal: 4.49 ± 2.51 mm). Mean deviation in segmental gap width at the anterior and posterior sites ranged from 0.55 to 1.72 mm and was statistically significant at all four measurements. Mean contralateral condyle position differed significantly from the initial position (8.56 ± 4.31 mm). Intraoral plate exposure occurred in three patients without adjuvant radiotherapy; no extraoral exposure, fractures, or loosening were observed. Non-union between the mandible and SFF was found in three patients.

conclusionAs with other CAD/CAM-assisted mandibular reconstructions, SFF exhibit discrepancies between virtual planning and the postoperative outcome. The surrounding soft tissue bulk of the scapula can hinder the precise fit of cutting guides, potentially compromising reconstruction accuracy and contributing to increased deviations. Despite these challenges, CAD/CAM-assisted SFF demonstrates acceptable surgical predictability.

Indexed as

Computer-Aided DesignFree Tissue FlapsMandibular ReconstructionScapulaAgedBone PlatesCone-Beam Computed TomographyFemaleHumansImaging, Three-DimensionalMaleMiddle AgedPatient Care PlanningPrinting, Three-DimensionalRetrospective StudiesTomography, X-Ray ComputedAccuracyCAD/CAMFree bone transplantFree flapsMandibular reconstructionMicrovascular transplantPatient-specific implantScapula free flap

Identifiers

PMID41634287
PMCPMC12868107

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Registered trials

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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.