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Background <p>Mandibular reconstruction, with temporomandibular joint (TMJ) involvement, is a challenging procedure where precise evaluation of condylar displacement is critical for assessing functional and aesthetic outcomes. The complexity of this evaluation stems from anatomical variability, surgical techniques, and post-surgical changes, making consistent and reliable assessments difficult. This study assessed condylar displacement following mandibular reconstruction using a standardized protocol for reproducibility.</p> Methods <p>A retrospective analysis of patients treated at AOU Careggi, Florence (2019–2023), was conducted, with preoperative, immediate postoperative, and long-term CT scans analyzed across four groups: customized microvascular bone flaps, conventional bone flaps, customized plate implants, and soft tissue-only reconstructions.</p> Results <p>Customized bone flaps and plate implants minimized condylar displacement, while conventional bone flaps had initial misalignment, stabilizing over time. Soft tissue-only reconstructions led to complete condylar resorption after two years.</p> Conclusion <p>The study introduced a standardized protocol for assessing condylar shifts, highlighting the advantages of CAD/CAM-based techniques in preserving TMJ integrity, and suggesting further research for refining reconstructive strategies.</p>

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3-D Morphological Condylar Changes Post-Oncological Mandibular Reconstruction: Comparison of Surgical Techniques

  • 期刊论文

  • 发表日期：

    2026年1月20日

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  • Beatrice Pulli,
  • Marco Conti,
  • Marta Mencarelli,
  • Yary Volpe,
  • Giuseppe Spinelli

摘要

Background

Mandibular reconstruction, with temporomandibular joint (TMJ) involvement, is a challenging procedure where precise evaluation of condylar displacement is critical for assessing functional and aesthetic outcomes. The complexity of this evaluation stems from anatomical variability, surgical techniques, and post-surgical changes, making consistent and reliable assessments difficult. This study assessed condylar displacement following mandibular reconstruction using a standardized protocol for reproducibility.

Methods

A retrospective analysis of patients treated at AOU Careggi, Florence (2019–2023), was conducted, with preoperative, immediate postoperative, and long-term CT scans analyzed across four groups: customized microvascular bone flaps, conventional bone flaps, customized plate implants, and soft tissue-only reconstructions.

Results

Customized bone flaps and plate implants minimized condylar displacement, while conventional bone flaps had initial misalignment, stabilizing over time. Soft tissue-only reconstructions led to complete condylar resorption after two years.

Conclusion

The study introduced a standardized protocol for assessing condylar shifts, highlighting the advantages of CAD/CAM-based techniques in preserving TMJ integrity, and suggesting further research for refining reconstructive strategies.