Abstract
OBJECTIVE: To explore and validate the effect of a tooth-supported osteotomy guide plates in assisting mandibular segmental resection, and to evaluate its impact on surgical precision. METHODS: A retrospective analysis was conducted on the clinical data of 22 patients who underwent mandibular segmental resection with preoperative digital guide design between January 2023 and June 2025. Patients were divided into two groups according to the placement method of the auxiliary plate: the tooth-supported group and the control group using the traditional guide plate, with 11 patients in each group. There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, postoperative pathological type, tumor stage, or disease duration. The operation time and intraoperative blood loss were compared between the two groups. At 3 months postoperatively, cone-beam CT scanning were used to measure deviations in the mandibular menton, condylar, and gonion points between pre- and post-operative measurements. Additionally, the number of occlusal contact points before and after operation was recorded for both groups, and occlusal contact deviations were compared. RESULTS: All surgeries were successfully completed, and there was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). The surgical incisions in both groups healed by first intention, and the skin flaps survived without complications such as vascular crises, infections, or fluid accumulation. All donor site wounds healed by first intention without wound dehiscence or infection. The patients were followed up 3-6 months, with a mean of 4.5 months. The tooth-supported group showed smaller deviations at the menton, condylar, and gonion points compared to the control group, and the number of occlusal contact deviations in both the sagittal and lateral occlusion were fewer in the tooth-supported group, with significant differences ( P<0.05). During the follow-up, the facial appearance recovered well, and the flaps were not bloated. Due to the influence of osteotomy and scar, all the 22 patients had mild limitation of mouth opening. CONCLUSION: Tooth-supported osteotomy guide plate can significantly improve the accuracy of guide plate placement, which has important clinical significance for improving the accuracy of mandibular tumor resection and the accuracy of mandibular reconstruction.