Abstract
The aim of this study was to analyse the radiological and clinical outcomes of condylar
reconstruction by fibula free flap (FFF), comparing conventional freehand and CAD/CAM
techniques. Fifteen patients (nine CAD/CAM, six freehand) who underwent condylar reconstruction
with a FFF were reviewed retrospectively regarding pre- and postoperative computed
tomography/cone beam computed tomography scans and clinical function. After surgery,
all patients were free of temporomandibular joint pain. Mean postoperative mouth opening
was 30.80 mm, with no significant difference between the freehand and CAD/CAM groups.
In all patients, laterotrusion was decreased to the contralateral side (P = 0.002), with no difference between freehand and CAD/CAM, while the axis of mouth
opening deviated to the side of surgery (P < 0.001). All patients showed significant radiological deviation of the fibular neocondyle
in the laterocaudal direction (lateral: P = 0.015; caudal: P = 0.001), independent of the technique. In conclusion, reconstruction of the mandibular
condyle by FFF provided favourable functional results in terms of mouth opening, reduction
of pain, and mandibular excursions. Radiological deviation of the neocondyle and deviation
of laterotrusion and mouth opening did not impair clinical function. CAD/CAM planning
facilitated surgery, decreased the surgery time, and improved the fit of the neocondyle
in the fossa.
Keywords
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Article info
Publication history
Published online: September 07, 2022
Accepted:
August 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
