Digital protocol application in the treatment of mandibular fractures
下颌骨骨折治疗中的数字化方案应用
Применение цифрового протокола при лечении переломов нижней челюсти
Gorodkov Z.E. Pylkov A.I. Golavskii P.I.
September 2025All-Russian Federation of the Specialists in Head and Neck Diseases
Head and Neck Russian Journal
2025#13Issue 335 - 42 pp.
Objective: To evaluate the effectiveness of a digital osteosynthesis protocol using patient-specific surgical guides in the treatment of mandibular fractures. Material and Methods. This prospective cohort study included 275 patients with unilateral linear mandibular fractures involving displacement at the level of the mandibular canal. All patients underwent treatment at the Department of Maxillofacial Surgery of the S.V. Belyaev Clinical Hospital (GAUZ “KOKB”) between 2020 and 2024. Patients were divided into two groups: in Group I (n=142), osteosynthesis was performed using a conventional protocol, while in Group II (n=133), a digital protocol was applied. The digital approach involved preoperative 3D modeling, virtual repositioning of bone fragments, and the design of patient-specific surgical guides (PSSG), which were fabricated using 3D printing. Fixation was achieved with titanium plates placed on the bone surface. The incidence of the following complications was analyzed: mandibular canal injury, dental root and periodontal tissue damage, nonunion, and postoperative wound infection. Statistical analysis included descriptive statistics, comparison of complication rates between groups, calculation of relative risk (RR), and 95% confidence intervals (CIs). Results. The use of the digital osteosynthesis protocol significantly reduced the risk of mandibular canal injury (p<0.001), with an RR of 8.74 (95% CI 3.90–19.61) in the conventional protocol group. A statistically significant reduction in the incidence of dental root and periodontal tissue damage was also observed in the digital protocol group, with an RR=5.62 (95% CI 1.28–24.64; p=0.019). No statistically significant differences were found between the groups in terms of nonunion (p=0.828) and postoperative infection rates (p=1.000). Conclusion. The study demonstrated the high effectiveness of the digital osteosynthesis protocol using patient-specific surgical guides in the management of mandibular fractures. This approach significantly reduces the incidence of complications such as mandibular canal and dental root injury and improves surgical accuracy. © Team of authors, 2025 /
3D modeling , digital protocol , mandibular fractures , osteosynthesis , patient-specific surgical guides
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Department of Surgical Dentistry and Maxillofacial Surgery, Kemerovo State Medical University of the Ministry of Health of the Russian Federation, 22a Voroshilova str., Kemerovo, 650056, Russian Federation
Department of Maxillofacial Surgery, Plastic and Reconstructive Surgery, Kuzbass Regional Clinical Hospital named after S.V. Belyaev, 22 Oktyabrsky Prospekt, Kemerovo, 650066, Russian Federation
Department of Therapeutic and Surgical Dentistry, Astana Medical University, Astana, Kazakhstan
Department of Surgical Dentistry and Maxillofacial Surgery
Department of Maxillofacial Surgery
Department of Therapeutic and Surgical Dentistry
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