Intraoral Condylectomy with 3D-Printed Cutting Guide versus with Surgical Navigation: An Accuracy and Effectiveness Comparison

This study compares the accuracy and effectiveness of our novel 3D-printed titanium cutting guides with intraoperative surgical navigation for performing intraoral condylectomy in patients with mandibular condylar osteochondroma (OC). A total of 21 patients with mandibular condylar OC underwent intraoral condylectomy with either 3D-printed cutting guides (cutting guide group) or with surgical navigation (navigation group). The condylectomy accuracy in the cutting guide group and navigation group was determined by analyzing the three-dimensional (3D) discrepancies between the postoperative computed tomography (CT) images and the preoperative virtual surgical plan (VSP). Moreover, the improvement of the mandibular symmetry in both groups was determined by evaluating the chin deviation, chin rotation and mandibular asymmetry index (AI). The superimposition of the condylar osteotomy area showed that the postoperative results were very close to the VSP in both groups. The mean 3D deviation and maximum 3D deviation between the planned condylectomy and the actual result were 1.20 +/- 0.60 mm and 2.36 +/- 0.51 mm in the cutting guide group, and 1.33 +/- 0.76 mm and 4.27 +/- 1.99 mm in the navigation group. Moreover, the facial symmetry was greatly improved in both groups, indicated by significantly decreased chin deviation, chin rotation and AI. In conclusion, our results show that both 3D-printed cutting-guide-assisted and surgical-navigation-assisted methods of intraoral condylectomy have high accuracy and efficiency, while using a cutting guide can generate a relatively higher surgical accuracy. Moreover, our cutting guides exhibit user-friendly features and simplicity, which represents a promising prospect in everyday clinical practice.