The utility of patient-specific surgical plates in free flap mandibular reconstruction: A systematic review and meta-analysis.

[PURPOSE] To evaluate the accuracy and clinical outcomes using patient-specific surgical plates (PSSPs) in mandibular reconstruction.

[METHODS] MEDLINE, EMBASE, Scopus, and Web of Science were searched. Study, patient, PSSP characteristics, and clinical outcomes from eligible studies were extracted using a standardized form. The risk of bias was assessed using the Cochrane Risk of Bias tool. Statistical significance for descriptive variables was evaluated using a t-test and chi-square tests. Common and random effects models were used for the meta-analysis. Inter-study heterogeneity was tested using the I test.

[RESULTS] Our search strategy yielded 1238 records, 12 of which met our eligibility criteria. Overall, the included studies provided a pooled participant size of 585 patients, of which 260 were in the intervention group, and 325 were in the control group. In our meta-analysis, PSSPs were associated with significantly lower intercondylar distance deviation (MD -2.15, 95% CI: -2.81 to -1.49) and intergonial distance deviation (MD -3.62, 95% CI: -6.77 to -0.47). However, the intercondylar angle deviation did not differ between PSSPs and controls. In addition, PSSPs may lead to shorter operative times (MD -77.18 min, 95% CI: -101.99 to -52.36) without significant differences in the length of hospital stay or the rates of postoperative complications.

[CONCLUSION] Our results indicate that PSSPs have the potential to improve clinical outcomes in mandibular reconstruction, particularly in reducing operative times and improving reconstruction accuracy. However, moderate-to-high heterogeneity and a high risk of bias underscore the need for further research, especially randomized controlled trials, for a more robust analysis.