The 3D tongue depressor guide: a low-cost alternative to 3D printing in fibula-based mandibular reconstruction

Conventional techniques for fibular osteotomy planning are intrinsically erroneous. 3D-printed osteotomy guides are time-consuming, require expensive software, and cannot accommodate changes in surgical plan. This study evaluated the form, function, and esthetics of patients who underwent fibular reconstruction using a novel technique for osteotomy planning. Patients who required multi-segment fibular reconstruction of the mandible were enrolled. The unique 3D osteotomy guide was fabricated intraoperatively using wooden tongue depressors. Functional outcomes like the interincisal distance, occlusion, jaw deviation, and oral competence were measured at preoperative (T1), 1 month (T2), and 6 months post-op (T3). Esthetic outcomes assessed were facial symmetry and mandibular projection. The reconstructive accuracy was gauged by CT measurements of bigonial width, mandibular arch angle, and ramus length. Thirty of the 61 patients met the inclusion criteria. The interincisal distance significantly improved from T1 to T2 and T3 (p