# 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.

## Key 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.