Comparison Between Preplated and Custom-Made Reconstructive Plates in Mandibular Reconstruction with Free Fibula Flap: A Retrospective and Multi-Center Study

Objective: A two-center, retrospective study was conducted on patients who underwent mandibular reconstruction surgery with fibula free flap from 2017 to 2023 at the departments of maxillofacial surgery of Perugia (Group I) and Ancona (Group II) hospitals. Methods: Patients were divided based on the type of reconstruction: Group I with preplating of standard plates on the stereolithographic model (19 patients) and Group II with custom-made plates (19 patients). Surgical and radiological parameters were compared to evaluate the precision of the two surgical techniques. Results: The average of the differences between the specific mandibular distances calculated at the pre- and postoperative CT showed values of 1.19 mm (95% CI: 0.601–3.783 mm) for Group I and +1.73 mm (95% CI: 0.505–3.033 mm) for Group II. The average of the differences between the mandibular angle was for Group I +3.5° (95% CI: 0.5°–4.4°), and for Group II 3.65° (95% CI: 0.7°–5.2°). The statistical analysis showed no significant difference between the two groups. Conclusions: The two techniques showed similar precision and excellent aesthetic and functional results, with specific advantages in production time, cost, and soft tissue projection.