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Original Research

Open Access

Digitally driven surgical guide planning

  • Chenchen Zhang1
  • Chi Song1
  • Dong Wang1
  • Tingyi Gao1
  • Jie Li1
  • Dongkun Yang1
  • Chang Liu1
  • Yue Du1
  • Kai Zhang1,*,

1Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, 233004 Bengbu, Anhui, China

DOI: 10.22514/jocpd.2024.014 Vol.48,Issue 1,January 2024 pp.128-137

Submitted: 18 April 2023 Accepted: 15 June 2023

Published: 03 January 2024

*Corresponding Author(s): Kai Zhang E-mail:


To investigate the role of a fully digital process in the surgical treatment of mandibular fractures in children. We analyzed a complete dataset from 22 children with mandibular fractures treated with digital surgical assistance. The patient’s treatment process included preoperative thin layer CT (Computed Tomography) scanning, computer-aided design (3D reconstruction, virtual reduction, and internal fixation device determination and shaping), and 3D printing (jaw model, bite plate). We used occlusal and shaping plates during surgery to assist in fracture reduction and fixation. During the follow-up, we observed the occurrence of fracture healing, occlusal relationships, opening degrees, and complications in pediatric patients after surgery. Next, we used the 3D overlay function of MIMICS software to compare the preoperative surgical design with postoperative jaw imaging data to evaluate the overall surgical effect. The postoperative imaging data showed good fracture healing, normal occlusion during follow-up, and significant improvement in opening degrees. The mean preoperative opening degree was 23.59± 2.89 mm, and the mean postoperative opening degree was 29.82 ± 1.79 mm; there was a significant difference between these two parameters (p < 0.05). There were no complications such as tooth germ injury, nerve injury or fracture block displacement. The postoperative mandibular imaging data was imported into MIMICS software for 3D overlay visualization, and the postoperative mandibular morphology recovery was well-matched with the preoperative design. We measured the average upper deviation (0.65 ± 0.09) mm and the average lower deviation (−0.57 ± 0.14) mm. The fully digital process has a precise, minimally invasive, and safe effect in the surgical treatment of mandibular fractures in children, and the clinical effect is satisfactory.


Digital surgery; Children; Mandibular fracture; Surgical treatment

Cite and Share

Chenchen Zhang,Chi Song,Dong Wang,Tingyi Gao,Jie Li,Dongkun Yang,Chang Liu,Yue Du,Kai Zhang. Digitally driven surgical guide planning. Journal of Clinical Pediatric Dentistry. 2024. 48(1);128-137.


[1] Oleck NC, Dobitsch AA, Liu FC, Halsey JN, Le TT, Hoppe IC, et al. Traumatic falls in the pediatric population. Annals of Plastic Surgery. 2019; 82: S195–S198.

[2] Lee CC, Tannyhill RJ, Peacock ZS. What factors are associated with open treatment of pediatric mandibular fractures? Journal of Oral and Maxillofacial Surgery. 2021; 79: 1292–1301.

[3] Bilgen F, Ural A, Bekerecioğlu M. Our treatment approach in pediatric maxillofacial traumas. Journal of Craniofacial Surgery. 2019; 30: 2368–2371.

[4] Zhao L, Zhang X, Guo Z, Long J. Use of modified 3D digital surgical guides in the treatment of complex mandibular fractures. Journal of Cranio-Maxillofacial Surgery. 2021; 49: 282–291.

[5] Chakravarthy C, Gupta NC, Patil R. A simplified digital workflow for the treatment of pediatric mandibular fractures using three-dimensional (3D) printed cap splint: a case report. Craniomaxillofacial Trauma & Reconstruction Open. 2019; 3: s-0039–1694765.

[6] Yesantharao PS, Lopez J, Reategui A, Najjar O, Yu JW, Pourtaheri N, et al. Open reduction, internal fixation of isolated mandible angle fractures in growing children. Journal of Craniofacial Surgery. 2020; 31: 1946–1950.

[7] Gandhi G, Sharma A, Soodan KS, Patidar D. Mandibular fracture in children: a new approach for management and review of literature. International Journal of Clinical Pediatric Dentistry. 2019; 12: 356–359.

[8] Sobrero F, Roccia F, Galetta G, Strada C, Gerbino G. Pediatric mandibular fractures: surgical management and outcomes in the deciduous, mixed and permanent dentitions. Dental Traumatology. 2023; 39: 233–239.

[9] Kao R, Rabbani CC, Patel JM, Parkhurst SM, Mantravadi AV, Ting JY, et al. Management of mandible fracture in 150 children across 7 years in a US tertiary care hospital. JAMA Facial Plastic Surgery. 2019; 21: 414–418.

[10] Bansal A, Yadav P, Bhutia O, Roychoudhury A, Bhalla AS. Comparison of outcome of open reduction and internal fixation versus closed treatment in pediatric mandible fractures—a retrospective study. Journal of Cranio-Maxillofacial Surgery. 2021; 49: 196–205.

[11] Bae SS, Aronovich S. Trauma to the pediatric temporomandibular joint. Oral and Maxillofacial Surgery Clinics of North America. 2018; 30: 47–60.

[12] Rostyslav Y, Yakovenko L, Irina P. Fractures of the lower jaw in children (causes, types, diagnosis and treatment). Retrospective 5 year analysis. Journal of Oral Biology and Craniofacial Research. 2020; 10: 1–5.

[13] Yan G, Chuo W, Zhang R, Zhou Q, Yang M. Evaluation of the effect of bioresorbable plates and screws in the treatment of condylar fractures, assisted by digital preoperative planning. Journal of Oral and Maxillofacial Surgery. 2019; 77: 1434.e1–1434.e16.

[14] Façanha de Carvalho E, Alkmin Paiva GL, Yonezaki F, Machado GG. Computer-aided surgical simulation in severe atrophic mandibular fractures: a new method for guided reduction and temporary stabilization before fixation. Journal of Oral and Maxillofacial Surgery. 2021; 79: 892.e1–892.e7.

[15] Kongsong W, Sittitavornwong S. Utilization of virtual surgical planning for surgical splint-assisted comminuted maxillomandibular fracture reduction and/or fixation. Craniomaxillofacial Trauma & Reconstruction. 2020; 13: 334–341.

[16] Lo L, Niu L, Liao C, Lin H. A novel CAD/CAM composite occlusal splint for intraoperative verification in single-splint two-jaw orthognathic surgery. Biomedical Journal. 2021; 44: 353–362.

[17] Williams A, Walker K, Hughes D, Goodson AMC, Mustafa SF. Accuracy and cost effectiveness of a waferless osteotomy approach, using patient specific guides and plates in orthognathic surgery: a systematic review. British Journal of Oral and Maxillofacial Surgery. 2022; 60: 537–546.

[18] Façanha de Carvalho E, Alkmin Paiva GL, Yonezaki F, Machado GG. Computer-aided surgical simulation in severe atrophic mandibular fractures: a new method for guided reduction and temporary stabilization before fixation. Journal of Oral and Maxillofacial Surgery. 2021; 79: 892.e1–892.e7.

[19] Ramanathan M, Panneerselvam E, Krishna Kumar Raja VB. 3D planning in mandibular fractures using CAD/CAM surgical splints—a prospective randomized controlled clinical trial. Journal of Cranio-Maxillofacial Surgery. 2020; 48: 405–412.

[20] Marschall JS, Dutra V, Flint RL, Kushner GM, Alpert B, Scarfe W, et al. In-house digital workflow for the management of acute mandible fractures. Journal of Oral and Maxillofacial Surgery. 2019; 77: 2084.e1–2084.e9.

[21] Zoabi A, Redenski I, Oren D, Kasem A, Zigron A, Daoud S, et al. 3D printing and virtual surgical planning in oral and maxillofacial surgery. Journal of Clinical Medicine, 2022; 11: 2385.

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