Remodelling surgery with 3D printed patient specific surgical guides in patients with chronic diffuse sclerosing osteomyelitis/tendoperiostitis of the mandible, a case series

TL;DR

This case series explores the use of 3D printed surgical guides to improve outcomes in facial surgery for a rare jaw condition, showing potential for better symmetry and patient satisfaction.

Contribution

The study introduces the use of 3D printed patient-specific surgical guides for remodelling surgery in chronic mandibular DSO/TP.

Findings

Three patients underwent surgery with 3D guides, with two reporting satisfaction and one needing re-surgery.

The approach may reduce the risk of nerve damage and improve surgical predictability.

One patient cancelled surgery after accepting her asymmetry with psychological support.

Abstract

Patients with chronic diffuse sclerosing osteomyelitis/tendoperiostitis (DSO/TP) of the mandible may complain about facial asymmetry as a result of mandibular deformity, one of the characteristics of DSO/TP of the mandible. If the disease is fully extinguished, remodelling surgery could be performed to treat complaints of facial asymmetry. This study reports the results of remodelling surgery with three-dimensional (3D) designed- and -printed patient-specific surgical guides.

3D printed guides were designed and manufactured by using mirroring of the contralateral non-affected mandible. Subsequently, the surgical procedure was performed under general anaesthesia using these surgical guides.

Four patients (all female) aged 15 (±2.8) years were included. They all complained about facial asymmetry and were planned for surgery with patient-specific surgical guides. Three of those surgeries were performed, of which two patients were satisfied with the result and the other patient is planned for re-surgery because of persistent aesthetical complaints. The last patient cancelled her surgery, because she eventually accepted her asymmetry with the help of a psychologist.

The use of patient-specific surgical guides in remodelling surgery of the mandible could enable a more predicTable and symmetrical outcome, which could minimise the chance for re-surgery and could increase patient satisfaction. Furthermore, it could minimise the chance of iatrogenic damage to the inferior alveolar nerve.

Key words:Diffuse sclerosing osteomyelitis, chronic tendoperiostitis, pain, surgery, remodelling, 3D.

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