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Article

Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches

  • Authors:
    • Sho Katsura
    • Yoshihiro Morita
    • Ryotaro Kakimoto
    • Tetsuo Miyamoto
    • Kana Kashima
    • Emiko Ogasa
    • Yoshio Ueno
    • Ayano Tobe‑Nishimoto
    • Satoko Kishimoto
    • Yuka Matsumiya‑Matsumoto
    • Akinori Takeshita
    • Kazuhide Matsunaga
    • Narikazu Uzawa
  • View Affiliations / Copyright

    Affiliations: Department of Oral and Maxillofacial Oncology and Surgery, The University of Osaka Graduate School of Dentistry, Suita, Osaka 565‑0871, Japan, General Dental Restoration Laboratory, The University of Osaka Dental Hospital, Suita, Osaka 565‑0871, Japan
  • Article Number: 48
    |
    Published online on: November 25, 2025
       https://doi.org/10.3892/ol.2025.15401
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Abstract

Mandibular reconstruction following segmental resection, often necessitated by oral malignancies, is a complex procedure that markedly affects postoperative function and aesthetics. Computer‑assisted surgery (CAS) has emerged as a valuable tool for enhancing surgical precision in oncological head and neck reconstruction. The present study evaluated the accuracy of mandibular reconstruction using three approaches: Conventional (non‑CAS), outsourced CAS (TruMatch) and an in‑house CAS system developed at The University of Osaka Graduate School of Dentistry (Suita, Japan). A total of 32 cases, predominantly involving malignant tumors, were retrospectively analyzed using three‑dimensional model overlay techniques to compare pre‑ and postoperative outcomes. While both CAS methods significantly improved accuracy compared with the non‑CAS approach, no statistical difference was found between the outsourced and in‑house CAS groups. These findings suggested that in‑house CAS systems can achieve comparable precision to commercial solutions, offering a cost‑effective and accessible alternative for advanced mandibular reconstruction in oncology settings. The results support broader adoption of in‑house CAS approaches, particularly in time‑sensitive or resource‑limited cancer surgeries.
View Figures

Figure 1

The design image of the in-house
computer-assisted surgery system for mandibular reconstruction.
Although this system requires the use of a ready-made
reconstruction plate, the bone/plate-positioning device (arrow) is
essential for accurate placement.

Figure 2

Intraoperative images of mandibular
reconstruction using the non-computer-assisted surgery system. (A)
Intraoral image before surgery. (B) Attaching the mandibular
positioning plate (arrows). (C) After resection of the mandible.
(D) Adjustment of the scapula graft. (E) After scapula graft
fixation. (F) Postoperative panoramic radiograph.

Figure 3

Intraoperative images of mandibular
reconstruction using the TruMatch system. (A) Placement of cutting
guide devices, which also function as drilling guides for the
TruMatch plate. (B) After resection of the mandible. (C) After
placement of the TruMatch plate. (D) Adjustment of the scapula
graft. (E) After scapula graft fixation (arrows). (F) Postoperative
panoramic radiograph (arrows: the TruMatch plate and the grafted
scapula).

Figure 4

Intraoperative images of mandibular
reconstruction using the in-house computer-assisted surgery system.
(A) Placement of cutting guide devices (arrows). (B) After
resection of the mandible. (C) After placement of the plate and
bone/plate-positioning device. (D) After fixation of the plate. (E)
After removing the plate positioning device. (F) Adjustment of the
scapula graft. (G) After scapula graft fixation. (H) Postoperative
panoramic radiograph (arrows: The plate and the grafted
scapula).

Figure 5

Three-dimensional accuracy analysis
for a representative case from the non-computer-assisted surgery
group. The analysis results for this case show that the
preoperative condylar distance is 106.6 mm, the postoperative
condylar distance is 105.9 mm, the intercondylar distance, which
indicates the change in the condylar distance, is 0.7 mm, and the
3D deviation distance, which indicates the three-dimensional
displacement of the condylar, is 17.2 mm.

Figure 6

Occlusal relationship in TruMatch and
in-house CAS cases. (A) Preoperative occlusal relationship in a
TruMatch case. (B) Postoperative occlusal relationship in a
TruMatch case. (C) Preoperative occlusal relationship in an
in-house CAS case. (D) Postoperative occlusal relationship in an
in-house CAS case. CAS, computer-assisted surgery.

Figure 7

Comparison of 3D accuracy analysis
results. The results of comparing ICD and 3DD values for non-CAS,
TruMatch, and in-house CAS cases are shown. As shown in the graph
on the left, no significant difference is noted in ICD values among
the three groups. However, as shown in the graph on the right, the
3DD values were significantly smaller in the TruMatch and in-house
CAS groups compared to the non-CAS group. Lines represent the
median. *P<0.05. 3DD, 3D deviation distance; CAS,
computer-assisted surgery; ICD, intercondylar distance; ns, not
significant.
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Copy and paste a formatted citation
Spandidos Publications style
Katsura S, Morita Y, Kakimoto R, Miyamoto T, Kashima K, Ogasa E, Ueno Y, Tobe‑Nishimoto A, Kishimoto S, Matsumiya‑Matsumoto Y, Matsumiya‑Matsumoto Y, et al: Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches. Oncol Lett 31: 48, 2026.
APA
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E. ... Uzawa, N. (2026). Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches. Oncology Letters, 31, 48. https://doi.org/10.3892/ol.2025.15401
MLA
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E., Ueno, Y., Tobe‑Nishimoto, A., Kishimoto, S., Matsumiya‑Matsumoto, Y., Takeshita, A., Matsunaga, K., Uzawa, N."Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches". Oncology Letters 31.2 (2026): 48.
Chicago
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E., Ueno, Y., Tobe‑Nishimoto, A., Kishimoto, S., Matsumiya‑Matsumoto, Y., Takeshita, A., Matsunaga, K., Uzawa, N."Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches". Oncology Letters 31, no. 2 (2026): 48. https://doi.org/10.3892/ol.2025.15401
Copy and paste a formatted citation
x
Spandidos Publications style
Katsura S, Morita Y, Kakimoto R, Miyamoto T, Kashima K, Ogasa E, Ueno Y, Tobe‑Nishimoto A, Kishimoto S, Matsumiya‑Matsumoto Y, Matsumiya‑Matsumoto Y, et al: Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches. Oncol Lett 31: 48, 2026.
APA
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E. ... Uzawa, N. (2026). Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches. Oncology Letters, 31, 48. https://doi.org/10.3892/ol.2025.15401
MLA
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E., Ueno, Y., Tobe‑Nishimoto, A., Kishimoto, S., Matsumiya‑Matsumoto, Y., Takeshita, A., Matsunaga, K., Uzawa, N."Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches". Oncology Letters 31.2 (2026): 48.
Chicago
Katsura, S., Morita, Y., Kakimoto, R., Miyamoto, T., Kashima, K., Ogasa, E., Ueno, Y., Tobe‑Nishimoto, A., Kishimoto, S., Matsumiya‑Matsumoto, Y., Takeshita, A., Matsunaga, K., Uzawa, N."Evaluating computer‑assisted mandibular reconstruction: Outsourced vs. in‑house approaches". Oncology Letters 31, no. 2 (2026): 48. https://doi.org/10.3892/ol.2025.15401
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