{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:11:54Z","timestamp":1790442714497,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["163974"],"award-info":[{"award-number":["163974"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["17632"],"award-info":[{"award-number":["17632"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","award":["163974"],"award-info":[{"award-number":["163974"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","award":["17632"],"award-info":[{"award-number":["17632"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Poorly contoured mandibular reconstruction plates are associated with postoperative complications. Recently, a technique emerged whereby preoperative patient-specific reconstructive plates (PSRP) are developed in the hopes of eliminating errors in the plate-bending process. This study\u2019s objective is to determine if reconstructions performed with PSRP are more accurate than manually contoured plates. Ten Otolaryngology residents each performed two ex vivo mandibular reconstructions, first using a PSRP followed by a manually contoured plate. Reconstruction time, CT scans, and accuracy measurements were collected. Paired Student\u2019s t-test was performed. There was a significant difference between reconstructions with PSRP and manually contoured plates in: plate-mandible distance (0.39 \u00b1 0.21 vs. 0.75 \u00b1 0.31 mm, p = 0.0128), inter-fibular segment gap (0.90 \u00b1 0.32 vs. 2.24 \u00b1 1.03 mm, p = 0.0095), mandible-fibula gap (1.02 \u00b1 0.39 vs. 2.87 \u00b1 2.38 mm, p = 0.0260), average reconstruction deviation (1.11 \u00b1 0.32 vs. 1.67 \u00b1 0.47 mm, p = 0.0228), mandibular angle width difference (5.13 \u00b1 4.32 vs. 11.79 \u00b1 4.27 mm, p = 0.0221), and reconstruction time (16.67 \u00b1 4.18 vs. 33.78 \u00b1 8.45 min, p = 0.0006). Lower plate-mandible distance has been demonstrated to correlate with decreased plate extrusion rates. Similarly, improved bony apposition promotes bony union. PSRP appears to provide a more accurate scaffold to guide the surgeons in assembling donor bone segments, which could potentially improve patient outcome and reduce surgical time. Additionally, in-house PSRP can serve as a low-cost surgical simulation tool for resident education.<\/jats:p>","DOI":"10.3390\/jcm11185306","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T04:54:41Z","timestamp":1662699281000},"page":"5306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Benefits of Patient-Specific Reconstruction Plates in Mandibular Reconstruction Surgical Simulation and Resident Education"],"prefix":"10.3390","volume":"11","author":[{"given":"Khanh Linh","family":"Tran","sequence":"first","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0039-800X","authenticated-orcid":false,"given":"Matthew Lee","family":"Mong","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Scott","family":"Durham","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eitan","family":"Prisman","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s12663-015-0766-5","article-title":"Mandibular Reconstruction: Overview","volume":"15","author":"Kumar","year":"2015","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/archotol.124.1.46","article-title":"Oromandibular Reconstruction Using Microvascular Composite Flaps: Report of 210 Cases","volume":"124","author":"Urken","year":"1998","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_3","first-page":"405","article-title":"Step-by-step mandibular reconstruction with free fibula flap modelling","volume":"32","author":"Pellini","year":"2012","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1002\/hed.23382","article-title":"Value of preoperative mandibular plating in reconstruction of the mandible","volume":"36","author":"Prisman","year":"2013","journal-title":"Head Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1002\/hed.20455","article-title":"Efficacy of small reconstruction plates in vascularized bone graft mandibular reconstruction","volume":"28","author":"Farwell","year":"2006","journal-title":"Head Neck"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1002\/hed.25342","article-title":"Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap","volume":"41","author":"Yeh","year":"2018","journal-title":"Head Neck"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1002\/micr.30349","article-title":"Predictors of plate extrusion in oromandibular free flap reconstruction","volume":"38","author":"Prasad","year":"2018","journal-title":"Microsurgery"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.oraloncology.2018.06.008","article-title":"Risk of plate removal in free flap reconstruction of the mandible","volume":"83","author":"Wood","year":"2018","journal-title":"Oral Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1007\/s11548-015-1193-2","article-title":"Multicenter study on the use of patient-specific CAD\/CAM reconstruction plates for mandibular reconstruction","volume":"10","author":"Wilde","year":"2015","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/SAP.0000000000002006","article-title":"Virtual Surgical Planning for Mandibular Reconstruction with the Fibula Free Flap: A Systematic Review and Meta-analysis","volume":"84","author":"Barr","year":"2019","journal-title":"Ann. Plast. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1097\/PRS.0000000000005418","article-title":"Cost-Effectiveness Analysis of Virtual Surgical Planning in Mandibular Reconstruction","volume":"143","author":"Fatima","year":"2019","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.bjoms.2014.09.015","article-title":"Surgical planning and microvascular reconstruction of the mandible with a fibular flap using computer-aided design, rapid prototype modelling, and precontoured titanium reconstruction plates: A prospective study","volume":"53","author":"Gil","year":"2015","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1055\/s-0034-1371356","article-title":"Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques","volume":"7","author":"Wilde","year":"2014","journal-title":"Craniomaxillofac. Trauma Reconstr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3506","DOI":"10.1002\/hed.26404","article-title":"Clinical evaluation of an automated virtual surgical planning platform for mandibular reconstruction","volume":"42","author":"Wang","year":"2020","journal-title":"Head Neck"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/978-3-030-32254-0_26","article-title":"Variational Shape Completion for Virtual Planning of Jaw Recon-structive Surgery","volume":"11768","author":"Abdi","year":"2019","journal-title":"Lect. Notes Comput. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s40463-018-0320-9","article-title":"In house virtual surgery and 3D complex head and neck reconstruction","volume":"47","author":"Luu","year":"2018","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_17","first-page":"E781","article-title":"Predicting the Premorbid Shape of a Diseased Mandible","volume":"131","author":"Wang","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"105379","DOI":"10.1016\/j.oraloncology.2021.105379","article-title":"Versatility of a single piece scapular tip and lateral border free flap for mandibular reconstruction: A virtual study on angle correspondence","volume":"121","author":"Tran","year":"2021","journal-title":"Oral Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1002\/hed.26731","article-title":"Maxillectomy defects: Virtually comparing fibular and scapular free flap reconstructions","volume":"43","author":"Nguyen","year":"2021","journal-title":"Head Neck"},{"key":"ref_20","first-page":"E619","article-title":"Predicting the Number of Fibular Segments to Reconstruct Mandibular Defects","volume":"130","author":"Shkedy","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_21","first-page":"S70","article-title":"Three-dimensional biomodeling in complex mandibular reconstruction and surgical simulation: Prospective trial","volume":"40","author":"Dziegielewski","year":"2011","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ijom.2009.11.003","article-title":"Biomechanics of mandibular reconstruction: A review","volume":"39","author":"Wong","year":"2010","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1097\/scs.0b013e318069014f","article-title":"Use of Three-Dimensional Medical Modeling Methods for Precise Planning of Orthognathic Surgery","volume":"18","author":"Mavili","year":"2007","journal-title":"J. Craniofacial Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/01.PRS.0000065910.66161.DD","article-title":"Osteotomy to Treat Malocclusion following Reconstruction of the Mandible with the Free Fibula Flap","volume":"112","author":"Chang","year":"2003","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/jbm.b.30603","article-title":"Fracture of titanium plates used for mandibular reconstruction following ablative tumor surgery","volume":"80B","author":"Martola","year":"2006","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1080\/10255842.2016.1240788","article-title":"Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model","volume":"20","author":"Gutwald","year":"2016","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e310","DOI":"10.1016\/j.jcms.2012.01.013","article-title":"Prevention points for plate exposure in the mandibular reconstruction","volume":"40","author":"Onoda","year":"2012","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1001\/archotol.1997.01900020107016","article-title":"Factors Involved in Long- and Short-term Mandibular Plate Exposure","volume":"123","author":"Nicholson","year":"1997","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1002\/hed.20776","article-title":"Lateral oromandibular defect: When is it appropriate to use a bridging reconstruction plate combined with a soft tissue revascularized flap?","volume":"30","author":"Chepeha","year":"2008","journal-title":"Head Neck"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/lary.29706","article-title":"Association of Plate Contouring with Hardware Complications Following Mandibular Reconstruction","volume":"132","author":"Davies","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.ijom.2008.03.002","article-title":"Mandibular reconstruction in adults: A review","volume":"37","author":"Goh","year":"2008","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1177\/0194599820931069","article-title":"Natural History and Consequences of Nonunion in Mandibular and Maxillary Free Flaps","volume":"163","author":"Swendseid","year":"2020","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.bjoms.2016.12.010","article-title":"Mandibular reconstruction with vascularised bone flaps: A systematic review over 25 years","volume":"55","author":"Brown","year":"2017","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1002\/hed.26688","article-title":"Short- and long-term outcomes of three-dimensional printed surgical guides and virtual surgical planning versus conventional methods for fibula free flap reconstruction of the mandible: Decreased nonunion and complication rates","volume":"43","author":"May","year":"2021","journal-title":"Head Neck"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1055\/s-0033-1343953","article-title":"Union and Bone Resorption of Free Fibular Flaps in Mandibular Reconstruction","volume":"29","author":"Bartlett","year":"2013","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/01.prs.0000475796.61855.a7","article-title":"Long-Term Operative Outcomes of Preoperative Computed Tomography\u2013Guided Virtual Surgical Planning for Osteocutaneous Free Flap Mandible Reconstruction","volume":"137","author":"Chang","year":"2016","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e335","DOI":"10.1016\/j.joms.2017.07.019","article-title":"Non-Union Rates in Fibula Free-Flap Reconstruction of Head and Neck Oncologic Defects","volume":"75","author":"Claiborne","year":"2017","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jss.2018.03.022","article-title":"Prolonged operative duration is associated with complications: A systematic review and meta-analysis","volume":"229","author":"Cheng","year":"2018","journal-title":"J. Surg. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jobcr.2021.06.002","article-title":"Emerging simulation technologies in global craniofacial surgical training","volume":"11","author":"Mehrotra","year":"2021","journal-title":"J. Oral Biol. Craniofacial Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5306\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:04Z","timestamp":1760142484000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,9]]},"references-count":39,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11185306"],"URL":"https:\/\/doi.org\/10.3390\/jcm11185306","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,9]]}}}