The study aimed to evaluate the reproducibility and postoperative stability of a 3D printed surgical guide in mandibular reconstruction using osteocutaneous free flaps. Fifteen patients underwent simulation surgery with 3D surgical guides fabricated using preoperative CT images (T0) on 3D modeling software platforms Aview(R) Modeler by Coreline Soft or OnDemand3D by Cybermed. Postoperative CT scans were taken immediately, one week (T1), and six months (T2) after surgery. The study found the error of the 3D surgical guide ranged from 0.85 to 2.56 mm, with no differences in reproducibility based on the type of flap used. However, condylar error and error at the mandible midpoint were significantly different in fibular free flap (FFF). Six months post-surgery, condyles moved more than 2 mm in FFF but showed no significant movement in deep circumflex iliac artery free flap (DCIA). The findings suggest careful intraoperative flap fixation and close postoperative observation, especially for FFF cases.
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