Customized Titanium Plates for Preventing Mandibular Fractures in Lower Third Molar Extractions.

Abstract

The extraction of deeply impacted lower third molars is a common yet challenging surgical procedure associated with complications such as mandibular fractures, pain, and swelling. This study evaluated the effectiveness of customized 3D-printed titanium plates in reducing the risk of intraoperative iatrogenic mandibular fractures. This innovative approach aims to improve surgical outcomes, enhance patient safety, and boost confidence for both surgeons and patients. Eighteen patients with Pell and Gregory class II/IIIC impacted lower third molars underwent preoperative CBCT scans, which facilitated the design and fabrication of customized plates and drilling guides. The surgical procedure involved incision, flap elevation, precise plate placement, osteotomy, odontotomy, extraction, and the postoperative assessment of pain, swelling, trismus, and anxiety using validated scales and facial scanning. The results show that customized titanium plates successfully prevented mandibular fractures in all cases. Although initial postoperative discomfort, including swelling, trismus, and pain, was observed, significant improvements occurred within one week. This technique provided structural reinforcement during surgery and healing without adverse events or fractures. Customized 3D-printed titanium plates represent a safe and effective solution for minimizing mandibular fractures, offering promising improvements in surgical outcomes.