Virtual Surgery Planning Integration and 3D Printed Surgical Template for Osteotomy Mandibuloplasty in the Management of Bilateral Elongated Mandible

Virtual Surgery Planning (VSP) and 3D printed surgical template is an accurate method of surgical correction of dentofacial skeleton deformities. Traditional methods dictated that pre-operative measurement taken from scans prior to intra-operative bony removal. To achieve good symmetry and outcome, it requires surgeon’s experience and consumed a lot of surgical time. With the advancement of computer-aided surgery, VSP and 3D printed surgical template have gained foothold in oral and craniomaxillofacial surgery. The purpose of this report is to highlight the advantages of VSP and 3D printed surgical template in term of accuracy, decrease surgical time and reduce risk of complications. We presented a case of 21 years old male Malay, unknown medical illness, was referred to OMFS clinic with complaint of unhappiness with his facial vertical dimension for almost 5 years. Clinically, he presented with Class III facial skeleton with bilateral buccal and lingual bony expansion of mandible. Intraorally, patient having class III malocclusion, generalized spacing, multiple retained deciduous and missing teeth. CT scans reported with prominence of bilateral zygoma, narrowing of nasal aperture and bony expansion of bilateral lower border of mandible. 3D images of patient were then obtained, applied and superimposed to the normal facial bone retrieved from CT Bank Data. Excess bone identified and 3D printed surgical guide fabricated. Intra-operatively, 3D printed surgical template was applied as a guide during surgical osteotomy and mandibuloplasty. Post-operative findings noted significant improvement on vertical dimensions and facial symmetry. In conclusion, VSP and 3D printed surgical template does improve on accuracy, decrease surgical time and reduce risk of complications.