Mandibular defect reconstruction utilizing preoperative 3D modeling, plate pre-bending and a novel triad graft: a case report

The reconstruction of boney defects of the mandible are a challenge in surgical therapy despite advances in bone grafting. This case study details a 30-year-old female who sustained a gunshot wound to the mandible leaving a 5 cm boney defect. This defect was reconstructed utilizing preoperative three-dimensional (3D) planning, an accurately pre-bent reconstruction plate, and a novel “triad” construct of autogenous bone graft, demineralized bone matrix, and an osteoprotective membrane. This reconstruction workflow allowed maintenance of the contour of the mandible and bone regeneration while also acting as a barrier to other tissues. This new technique reduced operative donor site morbidity and decreased surgical time dramatically, allowing the patient to be discharged the same day. The patient has a 5-year follow-up with panorex film and a biopsy of the graft area showing normal cortical bone. This case report illustrates the combination of advanced technology and novel products which can decrease operating time, decrease anesthesia time, increase precision, and most importantly decrease patient morbidity.