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Hardware-associated complications, especially hardware fractures, almost invariably necessitate explantation. Recent advances in manufacturing techniques promise potential advantages over traditional methods, including increased fracture resistance. However, to date, there is no scientific evidence confirming whether these benefits translate to real-life clinical conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A total of 210 patients underwent SMR followed by alloplastic reconstruction between 2007 and 2019 at Hannover Medical School. The indications for SMR were tumor (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009208;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009196 squamous cell carcinoma) and osteoradionecrosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). The mean patient age was 60.61 years, with a range of 14 to 89 years. The cohort comprised 146 male patients (69.52%) and 64 female patients (30.48%). Of these, 113 patients underwent reconstruction using hand-bent reconstruction plates (RP), while 97 received patient-specific implants (PSI). The incidence of hardware-related complications (HRC) was compared between the RP and PSI groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HRC occurred in 72 cases (34.29%). Exposure of the implant accounted for 47 cases (22.38%) while fractures occurred in 18 cases (8.57%), showing no significant difference between PSI and RP. Time from diagnosis until resection and reconstruction was not delayed due to the use of PSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The choice of alloplastic manufacturing method does not affect HRC rates. PSI is offering benefits beyond fracture resistance and does not delay SMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>HRC remain challenging and may additionally impair patients\u2019 quality of life. In particular, hardware fractures often necessitate additional surgical interventions, underlining the need to identify the factors that contribute to their occurrence. To the best of the author\u2019s knowledge, this is the largest cohort study comparing RP and PSI with respect to HRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06875-y","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:59:34Z","timestamp":1776988774000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison between patient-specific implants and hand-bent plates in mandibular reconstruction"],"prefix":"10.1007","volume":"30","author":[{"given":"Max Lukas","family":"Linderkamp","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efthymios","family":"Papazacharias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Lewandowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan Alexander","family":"Bettag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Mast","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fritjof","family":"Lentge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Jehn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael-Tobias","family":"Neuhaus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils-Claudius","family":"Gellrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Korn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"issue":"12","key":"6875_CR1","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1007\/s11548-015-1193-2","volume":"10","author":"F Wilde","year":"2015","unstructured":"Wilde F, Hanken H, Probst F, Schramm A, Heiland M, Cornelius C (2015) Multicenter study on the use of patient-specific CAD\/CAM reconstruction plates for mandibular reconstruction. 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Approval was granted by the Ethics Committee of MHH (23rd May, 2025, No. 11908-BO-K-2025).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors, Nils-Claudius Gellrich and Philippe Korn, receive speaker\u2019s honoraria from KLS Martin-Group, Tuttlingen, Germany; DePuy Synthes\n                      \u00ae\n                      , Raynham, MA, USA; Straumann, Basel, Switzerland; and Brainlab, Munich, Germany.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}