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@PHDTHESIS{Lohn:1025055,
author = {Lohn, Britta},
othercontributors = {Modabber, Ali and Lichte, Philipp},
title = {{C}omparison of the accuracy of different slot properties
of 3{D}-printed cutting guides for raising free fibular
flaps using saw or piezoelectric instruments : an in vitro
study},
school = {Rheinisch-Westfälische Technische Hochschule Aachen},
type = {Dissertation},
address = {Aachen},
publisher = {RWTH Aachen University},
reportid = {RWTH-2026-00502},
pages = {1 Online-Ressource : Illustrationen},
year = {2025},
note = {Veröffentlicht auf dem Publikationsserver der RWTH Aachen
University 2026; Dissertation, Rheinisch-Westfälische
Technische Hochschule Aachen, 2025, Kumulative Dissertation},
abstract = {Purpose The free fibular fap (FFF) is a standard procedure
for the oral rehabilitation of segmental bone defects in the
mandible caused by diseases such as malignant processes,
osteonecrosis, or trauma. Digital guides and
computer-assisted surgery (CAS) can improve precision and
reduce the time and cost of surgery. This study evaluates
how different designs of slot cutting guides, guiding
heights, and cutting instruments affect surgical accuracy
during mandibular reconstruction. Methods Ninety model
operations in a three-part fibular transplant for mandibular
reconstruction were conducted according to digital planning
with three guide designs (standard, flange, and anatomical
slots), three guide heights (1 mm, 2 mm, 3 mm), and two
osteotomy instruments (piezoelectric instrument and saw).
The cut segments were digitized using computed tomography
and digitally evaluated to assess surgical accuracy. Results
For vestibular and lingual segment length, the anatomical
slot and the flange appear to be the most accurate, with the
flange slightly under-contoured vestibularly and the
standard slot over-contoured lingually and vestibularly (p <
0.001). There were only minor differences between the use of
saw and piezoelectric instrument for lingual (p = 0.005) and
vestibular (p < 0.001) length and proximal angle (p =
0.014). The U-distance after global reconstruction for
flanges resulted in a median deviation of 0.0468 mm (IQR
8.15), but was not significant (p = 0.067). Conclusion
Anatomical slots and flanges are recommended for osteotomy,
with guiding effects relying on both haptic and visual
control. Unilateral guided flanges also work accurately at
high guidance heights. The results of piezoelectric
instrument (PI) and saw showed comparable results in the
assessment of individual segments and U-reconstruction in
this in vitro study without soft tissue, so that the final
decision is left to the expertise of the surgeons.},
cin = {938010},
ddc = {610},
cid = {$I:(DE-82)545000-2_20140620$},
typ = {PUB:(DE-HGF)11},
doi = {10.18154/RWTH-2026-00502},
url = {https://publications.rwth-aachen.de/record/1025055},
}
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