Banerjee Annesha R, Zhao Linping, Purnell Chad, Svirinovska Nina, Alkureishi Lee
From the Department of Medicine, Cooper Medical School of Rowan University, Camden, NJ.
Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois Craniofacial Center, Chicago, IL.
Plast Reconstr Surg Glob Open. 2025 Apr 10;13(4):e6676. doi: 10.1097/GOX.0000000000006676. eCollection 2025 Apr.
Mandibular reconstruction with a free fibula flap is considered the gold standard for implant-based prosthodontic rehabilitation. Doing so with presurgical virtual planning has become commonplace, resulting in procedure-specific osteotomy guides and fixation plates, but is limited by a cumbersome user experience. A new virtual reality (VR)-based mandible reconstruction application, ImmersiveRecon, could address these shortcomings. This case report discusses a free fibula-based mandible reconstruction and osseointegrated dental implant placement surgery planned in VR. A 17-year-old man with a history of left hemimandibulectomy for ameloblastoma and prior failed free fibula reconstruction presented for surgical evaluation. The patient's preoperative computed tomography scans were imported into ImmersiveRecon, where planning was completed by the surgeon. Procedure-specific osteotomy guides, position templates, and splints were three-dimensionally printed for use during surgery. The VR planning method was analyzed by comparing preoperative, planned, and postoperative computed tomography scan measurements. VR planning was completed directly by the surgeon without engineer assistance, with a total planning time of 5 minutes. The surgery was completed without difficulty. The patient demonstrated excellent functional and aesthetic outcomes without complications, and prosthodontic rehabilitation was completed with the provision of a final implant-retained prosthesis. Comparison of measurements from the three-dimensionally planned models and postoperative models showed high fidelity and met the standards of the surgeon. VR surgical planning is feasible and provides several advantages over traditional surgical planning approaches, such as improved scan visualization, simplified user interface, and shorter planning sessions.
采用游离腓骨瓣进行下颌骨重建被认为是基于种植体的口腔修复重建的金标准。通过术前虚拟规划来进行该手术已变得很常见，可生成特定手术的截骨导板和固定板，但受限于繁琐的用户体验。一种新的基于虚拟现实（VR）的下颌骨重建应用程序ImmersiveRecon可以解决这些缺点。本病例报告讨论了在VR中规划的基于游离腓骨的下颌骨重建和骨整合牙种植体植入手术。一名17岁男性，有因成釉细胞瘤行左半侧下颌骨切除术病史且先前游离腓骨重建失败，前来接受手术评估。患者的术前计算机断层扫描图像被导入ImmersiveRecon，由外科医生完成规划。为手术过程制作了特定手术的截骨导板、定位模板和夹板并进行三维打印。通过比较术前、规划后和术后计算机断层扫描测量结果来分析VR规划方法。VR规划由外科医生直接完成，无需工程师协助，总规划时间为5分钟。手术顺利完成。患者功能和美学效果极佳，无并发症，通过提供最终的种植体固位假体完成了口腔修复。对三维规划模型和术后模型的测量结果比较显示出高保真度，符合外科医生的标准。VR手术规划是可行的，与传统手术规划方法相比具有多个优点，如改善扫描可视化、简化用户界面和缩短规划时间。
