{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:13:47Z","timestamp":1790856827913,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008127","name":"DePuy Synthes Spine","doi-asserted-by":"publisher","award":["DPS\u2010TCMF\u20102019\u2010051"],"award-info":[{"award-number":["DPS\u2010TCMF\u20102019\u2010051"]}],"id":[{"id":"10.13039\/100008127","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Examine accuracy and factors impacting accuracy for mandibular reconstruction with virtual surgical planning, 3D printed osteotomy guides and preoperatively bent mandibular reconstruction plate (VSP\/3Dprinted\u2010guide\/plate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Retrospective review of osseous\u2010free\u2010flap mandibular reconstructions with VSP\/3Dprinted\u2010guide\/plate between January 2015 and July 2020 at a single academic medical center.<\/jats:p><jats:p>Patient demographics, disease, and treatment variables were extracted. Accuracy was assessed by 3D\u2010model\u2010overlay with cephalometric and donor\u2010bone segment length measurements. Multivariate analyses were performed to determine factors impacting cephalometric accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>60 cases met criteria: 41 (68%) cancer, 14 (23%) osteoradionecrosis (ORN), 5 (8%) secondary mandibular reconstruction. Thirteen cases (22%) were Brown class III or IV. Thirty\u2010nine cases (65%) had \u22652 flap bone segments. Average donor\u2010bone length was 82\u2009mm (SD: 28). 3D\u2010model\u2010overlay accuracy demonstrated minimal deviation between planned and actual reconstruction: intercondylar distance\u00a0=\u00a02.10\u2009mm (SD: 2.2); intergonial distance\u00a0=\u00a02.23\u2009mm (SD: 1.9); anterior\u2013posterior distance (APD)\u00a0=\u00a01.76\u2009mm (SD: 1.5); gonial angle (GA)\u00a0=\u00a03.11 degrees (SD: 2.4). Mean change in donor\u2010bone segment length inferiorly was 2.67\u2009mm (SD: 2.6) and superiorly 3.27\u2009mm (SD: 3.2). Higher number of donor\u2010bone segments was associated with decreased accuracy in GA (<jats:italic>p<\/jats:italic>\u00a0=\u2009.023) and longer donor\u2010bone length was associated with decreased accuracy in APD (<jats:italic>p<\/jats:italic>\u00a0=\u2009.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To our knowledge this is the largest series assessing surgical accuracy of VSP\/3Dprinted\u2010guide\/plate for osseous\u2010free\u2010flap mandibular reconstruction. We demonstrate highly accurate results, with increased number of donor\u2010bone segments and donor\u2010bone length associated with decreased accuracy. Our findings further support VSP\/3Dprinted\u2010guide\/plate as a reliable and accurate tool for mandibular reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.830","type":"journal-article","created":{"date-parts":[[2022,10,22]],"date-time":"2022-10-22T06:45:25Z","timestamp":1666421125000},"page":"1798-1807","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Virtual planning and <scp>3D<\/scp>\u2010printed guides for mandibular reconstruction: Factors impacting accuracy"],"prefix":"10.1002","volume":"7","author":[{"suffix":"Jr","given":"Donald J.","family":"Annino","sequence":"first","affiliation":[{"name":"Division of Otolaryngology Brigham and Women's Hospital, Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts 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