Abstract: PURPOSE: To present a method for mandibular defects reconstruction with free fibular flap by three-dimensional virtual technology. METHODS: In 11 patients (8 with ameloblastomas, 1 with ossifying fibroma, 2 with carcinoma of the mandibular gingiva ), three-dimensional virtual technology was simulated with software. The osteotomies were translated into rapid prototyping guides. The solid model of the mandible and the surgical guides were the same as the full size and the shape, and made by using rapid prototyping machine. During operation, the bridging plate could be pre-bended on the repaired mandibular model. One group resected the diseased mandibular according to the model of the osteotomy which was planned before operation, the other group used auxiliary guide for accurate osteotomy of the fibula bone with contact pedicle. The fibular segments were reshaped and fixed with prefabricated titanium plate, and transplanted into the defect for vascular anastomosis. RESULTS：All the bone flaps and osteocutaneous flaps survived. During operation, the fibula flap could be cut in appropriate length. Cutting, remodeling and reposition of the fibula could be accelerated by surgery guides. Postoperative follow-up was 1 to 24 months. Imaging examination showed that the shape of mandible and mandibular angle were good, and the temporomandibular joint and occlusion returned to normal. CONCLUSIONS: Three-dimensional virtual technology is useful in reconstruction of mandibular defect with vascularized fibular flap.

Key words: Three-dimensional virtual technology, Free fibular flap, Mandibular defect, Rapid prototyping technique Shanghai J Stomatol, 2015, 24(4):460-464.