Innovative use of intraoperative computed tomography and intraoperative three-dimensional result verification in intraoral paediatric mandibular distraction

Surgical planning using three-dimensional (3D) technologies has become increasingly popular in complex procedures, notably in maxillofacial surgery. Most existing literature emphasizes preoperative planning and guide fabrication, with limited focus on intraoperative validation of these plans. This study presents a novel protocol incorporating intraoperative 3D planning and cone-beam computed tomography verification in paediatric mandibular distraction osteogenesis for hemifacial microsomia. The proposed workflow integrates preoperative 3D planning, 3D printing of surgical guides, and intraoperative CBCT assessment to evaluate distractor positioning and surgical accuracy in real time. A retrospective analysis of seven cases demonstrated that intraoperative planning enabled the detection of distractor deviations. The results show that the use of 3D technologies in the planning and execution of paediatric mandibular distraction procedures is a valuable tool that has the potential to improve the accuracy and efficiency of the surgical process. It allows for an intraoral approach, a personalized surgical planning, and real-time feedback during the procedure.