Abstract
Computerised surgical planning (CSP) and computer-aided design and manufacturing (CAD/CAM)
have been demonstrated to increase surgical accuracy and reduce operative time in
free flap mandibular reconstruction, but evidence is lacking as to their impact on
patient-centred outcomes. Implant-supported dental prostheses, however, have been
associated with improved quality of life outcomes following free flap mandibular reconstruction.
We aim to review reported patient-centred outcomes in mandibular reconstruction with
CSP and CAD/CAM and determine whether use of these technologies is associated with
higher rates of dental implant placement following free flap mandibular reconstruction.
On December 20, 2020, a systematic review and meta-analysis were conducted according
to PRISMA guidelines for studies reporting quality of life, functional outcomes, and
rates of dental implant placement in computer-aided free flap mandibular reconstruction.
A random-effects meta-analysis was performed to compare dental implant placement rates
between surgeries using CSP and those using conventional freehand techniques. A total
of 767 articles were screened. Nine articles reporting patient-centred outcomes and
16 articles reporting dental implant outcomes were reviewed. Of those reporting dental
implant outcomes, five articles, representing a total of 302 cases, were included
in the meta-analysis. Use of CSP was associated with a significant increase in the
likelihood of dental implant placement, with an odds ratio of 2.70 (95% CI 1.52 to
4.79, p = 0.0007). Standardised reporting methods and controlled studies are needed
to further investigate the impact of CSP and CAD/CAM technologies on functional outcomes
and patient-reported quality of life in free flap mandibular reconstruction. Use of
CSP and CAD/CAM technologies is associated with higher rates of dental implant placement
in patients undergoing free flap mandibular reconstruction when compared to conventional
freehand techniques.
Keywords
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Article info
Publication history
Published online: September 28, 2022
Accepted:
September 22,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
