Abstract：
This study aimed to compare the clinical outcomes and complication rates of patient-specific 3D-printed mini- and reconstruction plates for free flap fixation in mandibular reconstruction. A retrospective monocentric study was carried out between April 2017 and December 2021 to analyze patients undergoing immediate mandibular reconstruction using fibula free flaps and osteosynthesis using patient-specific 3D-printed implants. Eighty-three patients with a mean age of 63.6 years were included. The mean follow-up period was 18.5 months. Patient-specific 3D-printed plates were designed as reconstruction plates (38 patients), miniplates (21 patients) or a combination of reconstruction- and miniplates (24 patients). With miniplates, plate removal was performed significantly more often via an intraoral approach (p < 0.001) and in an outpatient setting (p = 0.002). Univariate analysis showed a higher fistula rate with reconstruction plates (p = 0.037). Multivariate analysis showed no significant differences in complications. Case-control matching demonstrated significantly lower rates of fistula (p = 0.017) and non-union (p = 0.029) in the combined group. This retrospective study shows a tendency towards reduced complication rates with patient-specific 3D-printed miniplates in comparison to patient-specific 3D-printed reconstruction plates for immediate mandibular reconstruction with fibula free flaps.
摘要：
本研究旨在比较患者专用3D打印微型和重建板在下颌骨重建中用于游离皮瓣固定的临床结果和并发症发生率。在2017年4月至2021年12月之间进行了一项回顾性单中心研究，以分析使用无腓骨皮瓣和使用患者特定的3D打印植入物进行骨合成的即时下颌骨重建的患者。包括83例平均年龄为63.6岁的患者。平均随访时间为18.5个月。患者特定的3D打印板被设计为重建板（38名患者），微型板（21例）或重建和微型板的组合（24例）。有迷你盘子，通过口内方法(p<0.001)和门诊患者(p=0.002)进行钢板摘除的次数明显增多.单因素分析显示重建板的瘘率较高（p=0.037）。多因素分析显示并发症差异无统计学意义。病例对照匹配显示，在联合组中，瘘管（p=0.017）和不愈合（p=0.029）的发生率显着降低。这项回顾性研究显示，与患者特定的3D打印重建板相比，患者特定的3D打印微型板具有降低并发症发生率的趋势。
