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Image 3.
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Using Planmeca ProModel and original
3D images of the patient, osteotomy lines
were drawn in virtual 3D modelling software.
Image 1 shows the osteotomy lines drawn to
achieve safe and clear margins.
Template shows volume, shape and
correct angles
Virtual operation was executed using 3D
CAD model. After this, an autoclavable
Planmeca ProModel, an accurate replica
of the mandible to be resected, excluding
the tumour, was built.
The model was then used as guiding
device, i.e. template, during the operation for operation area.
raising the bone flap similar in shape to the
resected part of the mandible. The Planmeca
ProModel template en­abled accurate bone
Image 2. Autoclavable
The autoclavable
Planmeca ProModel
template is at
the inferior border
of the mandible.
Image 4. Resected
tumour and Planmeca
ProModel. Needle at
the centre of the tumour.
4a. anterior view, and 4b
lateral view.
reconstruction during the operation, pro­
viding the volume, the shape of the bone flap,
and precise angles of the osteotomy lines
required to build new anterior part for the
mandible. Image 2 shows the autoclavable
Planmeca ProModel of the patient’s man‑​
dible without the tumour.
Utilising the template in
the treatment situation
The initial part of the surgery was carried
out with routine techniques. Bilateral neck
dissection was performed, after which
submandible skin incision was extended
to perform a lip split for good visual field to border of the mandible, immediately before
Mucosal incision was done with 15 mm
clear margin to tumour. Not to approach the
Planmeca ProModel
showing resected anterior
mandible (template).
Image 1. Osteotomy
lines with margins,
and virtual cut of
the mandible.
tumour region, the inferior border on
mandible was exposed.
The Planmeca ProModel template,
pre­cise copy of the virtual resection, was
mount­ed to the inferior bone exposed, and
the act­ual resection was carried out utilising
the dimensions and cutting angles of the
template. Similarly, another duplicate of
the same template was used to raise the free
bone flap as an exact copy of resected
mand­ ible.
Image 3 shows the phase of the operation
with template mounted to the inferior
sawing the mandible.
Images 4a and 4b show the resected
mandible and the anterior floor of the mouth,
as well as the tongue.