Lo Giudice Giorgio, Calvo Alessandro, Magaudda Emanuele, De Ponte Francesco Saverio, Nastro Siniscalchi Enrico
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Maxillo-Facial Surgery Unit, University Hospital "G. Martino", University of Messina, Messina, Italy.
Department of Medicine and Surgery, University of Enna "Kore", Enna, Italy.
Front Oral Health. 2025 Mar 28;6:1520195. doi: 10.3389/froh.2025.1520195. eCollection 2025.
The use of anatomical models, guides, and surgical templates allows for increased precision of interventions and reduced operative times. Thanks to computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies and rapid prototyping through 3D printing, it is possible to obtain accurate models, which are useful to defining surgical planning in the maxillofacial district.
We present the case of a patient with a pathological fracture of the mandibular body affected by medication-related osteonecrosis of the jaws (MRONJ) in stage III. Through the manipulation of virtual models obtained from thin-layer Computed Tomography (CT), a virtual surgical intervention of sequestrectomy and debridement of necrotic bone tissue, reduction and containment of the fracture was performed. The resulting mandibular model was used as a template for the preoperative modeling of the titanium reconstruction plate used for fracture containment.
The intraoperative result and follow-up demonstrated good accuracy of the model with respect to post-operative mandibular dynamics, condylar-fossa position and a reduced surgical time.
Virtual surgery and 3D-printed prototyping represent a feasible technique in MRONJ patients, allowing increased precision of interventions, reduced risks associated with the operation, and improved operative and recovery times for the patient.
使用解剖模型、导向器和手术模板可提高干预的精确度并缩短手术时间。借助计算机辅助设计（CAD）和计算机辅助制造（CAM）技术以及通过3D打印进行快速成型，能够获得精确的模型，这对于确定颌面区域的手术规划很有用。
我们介绍了一名患有下颌骨体病理性骨折的患者，其患有III期药物相关性颌骨坏死（MRONJ）。通过对从薄层计算机断层扫描（CT）获得的虚拟模型进行操作，对坏死骨组织进行了死骨切除术和清创术的虚拟手术干预，对骨折进行了复位和固定。所得的下颌骨模型被用作术前制作用于骨折固定的钛重建板的模板。
术中结果和随访表明，该模型在术后下颌动力学、髁突-关节窝位置方面具有良好的准确性，并且手术时间缩短。
虚拟手术和3D打印原型制作是MRONJ患者的一种可行技术，可提高干预的精确度，降低手术相关风险，并改善患者的手术和恢复时间。
