Contouring a Jaw in the Operating Room: How 3D Printing Changed the Calculation

The patient had an oral cancer — a tumour on the right jaw. Surgical removal with a safe margin was necessary to prevent the disease spreading. Without reconstruction following that removal, the outcomes would be severe: difficulty speaking and swallowing, facial asymmetry, low social acceptance, and reduced ability to work. Microvascular free bone transfer — taking bone from another part of the body and re-attaching it with its blood supply — offered a path to restoration.

The procedure chosen was a fibula free flap: bone from the lower leg, taken along with its blood vessels, contoured to replace the resected jaw segment, and fixed in place with the vascular connections re-established in the neck. One artery carries oxygenated blood to the new bone; at least one vein carries deoxygenated blood back. Done correctly, the transplanted bone stays alive and integrates.

The central challenge is contouring. A fibula is straight. A jaw is curved and three-dimensional. Getting that shape right — particularly in large reconstructions — requires the surgeon to work from spatial reasoning and experience, contouring the bone intraoperatively while the transplant clock runs. Any error in shape or symmetry will affect the patient's final facial appearance, occlusion, and ability to receive dental implants later.

Osteo3d prepared a sterilisable 3D printed model of the jaw for the maxillofacial surgeon prior to the procedure. The model was taken into the operating theatre. After the diseased jaw segment was removed, the fibula was harvested. The contouring was done against the 3D printed model — fit and shape verified before the bone was fixed to the defect. Symmetry was confirmed. The reconstruction proceeded.

The patient's immediate outcome was successful. Within a few weeks following recovery, he would be ready for dental implants — the next step toward full restoration of function and appearance.

This case demonstrated what became a consistent pattern across Osteo3d's mandibular reconstruction work: a sterilisable, patient-specific model in the OR reduces the intraoperative guesswork that most affects final symmetry and fit. The surgeon arrives having already solved the contouring problem. What remains is execution.