Mandibular Surgical Navigation: An Innovative Guiding Method

Mandibular osteotomies are usually required to treat craniomaxillofacial disorders. Losses of mandibular continuity result in esthetic and functional deficiency. During the past 30 years, the spread of the computer-assisted surgery techniques, rapid prototyping, and surgical navigation technique has improved the reliability and the outcomes of mandibular resections and reconstructions, by providing realtime feedback to surgeon. Recent studies reported the feasibility and the precision of surgical navigation applied to mandibular surgical resection and reconstruction with fibula flap but none of them describes a method to navigate the jaw allowing its full motility during the operation. To our knowledge, this is the first-time description of such a kind of method to navigate the jaw positioning the dynamic reference frame directly on the mandibular branch to maintain the full mobility of the mandible. The method described in our series has allowed an accurate surgical navigation of the jaw without the need of intermaxillary fixation. This technique could greatly facilitate resection and reconstructive surgical procedures of the jaw while ensuring precision and accuracy. The encouraging results obtained in the present report suggest to further investigate the possibilities of this technique to better define the method and its indications.