Fibula Graft Cutting Devices: Are 3D-Printed Cutting Guides More Precise Than a Universal, Reusable Osteotomy Jig?

• Main Authors: Simon Meyer, Jan-Michaél Hirsch, Christoph S. Leiggener, Bilal Msallem, Guido R. Sigron, Christoph Kunz, Florian M. Thieringer
• Format: Article
• Language: English
• Published: MDPI AG 2020-12-01
• Series: Journal of Clinical Medicine
• Subjects: cranio-maxillofacial surgery; mandibular reconstruction; fibula; osteotomy; tissue transplantation; surgical guides
• Online Access: https://www.mdpi.com/2077-0383/9/12/4119

Individual cutting guides for the reconstruction of lower jaw defects with fibular grafts are often used. However, the application of these osteotomy tools is costly and time intensive. The aim of this study was to compare the precision of osteotomies using a 3D-printed guide with those using a universal, reusable, and more cost-efficient Multi-Use Cutting Jig (MUC-Jig). In this non-blinded experimental study, 10 cranio-maxillofacial surgeons performed four graft removals each in a randomized order using the same osteotomy angle, both proximally (sagittal cut) and distally (coronal cut), of a graft (45°, 30°, 15°, or 0°), first with the MUC-Jig then with the 3D-printed cutting guide. The 40 fibula transplants (Tx) of each method (n = 80) were then analyzed concerning their Tx length and osteotomy angles and compared to the original planning data. Furthermore, the surgeons’ subjective perception and the duration of the two procedures were analyzed. The mean relative length and mean relative angle deviation between the MUC-Jig (−0.08 ± 1.12 mm; −0.69° ± 3.15°) and the template (0.22 ± 0.90 mm; 0.36° ± 2.56°) group differed significantly (<i>p</i> = 0.002; <i>p</i> = < 0.001), but the absolute deviations did not (<i>p</i> = 0.206; <i>p</i> = 0.980). Consequently, clinically comparable osteotomy results can be achieved with both methods, but from an economic point of view the MUC-Jig is a more cost-efficient solution.