Virtual Surgical Planning for Mandibular Reconstruction in Paget Disease With Severe Deformity
- 1From the Department of Plastic and Reconstructive Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Abstract
Paget disease of the mandible is a rare metabolic bone disorder characterized by abnormal bone remodeling, resulting in deformity and structural weakness. Medical therapy, including bisphosphonates, is the most common treatment; however, chronic osteomyelitis is a known complication of mandibular Paget disease, and definitive management with mandibular resection and reconstruction has rarely been reported. Mandibular reconstruction in such cases is particularly challenging because severe deformity obscures normal anatomical landmarks. Virtual surgical planning (VSP) and patient-specific reconstruction systems have been developed to improve surgical accuracy in complex maxillofacial reconstruction. However, their application in Paget disease with severe mandibular deformity has never been described. We report a case of mandibular resection and reconstruction using VSP in a patient with Paget disease of the mandible complicated by chronic osteomyelitis. Due to the absence of reliable anatomical reference, VSP was essential to determine resection margins and reconstruction geometry. Segmental mandibulectomy and free fibular flap reconstruction were performed according to the preoperative plan, resulting in satisfactory postoperative functional and aesthetic outcomes without recurrence of infection. This case suggests the potential utility of VSP for accurate and reliable mandibular reconstruction in Paget disease with severe deformity, where conventional techniques are limited.
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BibTeX
@article{erikotakeshima2026virtual,
title = {{Virtual Surgical Planning for Mandibular Reconstruction in Paget Disease With Severe Deformity}},
author = {Eriko Takeshima, MD and Shusaku Maeda, MD and Ayaka N. Deguchi, MD and Tadaaki Morotomi, MD, PhD and Hisashi Motomura, MD, PhD},
journal = {Plastic and Reconstructive Surgery, Global Open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008204},
url = {https://doi.org/10.1097/gox.0000000000008204},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Virtual Surgical Planning for Mandibular Reconstruction in Paget Disease With Severe Deformity
AU - Eriko Takeshima, MD
AU - Shusaku Maeda, MD
AU - Ayaka N. Deguchi, MD
AU - Tadaaki Morotomi, MD, PhD
AU - Hisashi Motomura, MD, PhD
PY - 2026
DA - 2026/10/29
JO - Plastic and Reconstructive Surgery, Global Open
DO - 10.1097/gox.0000000000008204
UR - https://doi.org/10.1097/gox.0000000000008204
AB - Paget disease of the mandible is a rare metabolic bone disorder characterized by abnormal bone remodeling, resulting in deformity and structural weakness. Medical therapy, including bisphosphonates, is the most common treatment; however, chronic osteomyelitis is a known complication of mandibular Paget disease, and definitive management with mandibular resection and reconstruction has rarely been reported. Mandibular reconstruction in such cases is particularly challenging because severe deformity obscures normal anatomical landmarks. Virtual surgical planning (VSP) and patient-specific reconstruction systems have been developed to improve surgical accuracy in complex maxillofacial reconstruction. However, their application in Paget disease with severe mandibular deformity has never been described. We report a case of mandibular resection and reconstruction using VSP in a patient with Paget disease of the mandible complicated by chronic osteomyelitis. Due to the absence of reliable anatomical reference, VSP was essential to determine resection margins and reconstruction geometry. Segmental mandibulectomy and free fibular flap reconstruction were performed according to the preoperative plan, resulting in satisfactory postoperative functional and aesthetic outcomes without recurrence of infection. This case suggests the potential utility of VSP for accurate and reliable mandibular reconstruction in Paget disease with severe deformity, where conventional techniques are limited.
SN - 2169-7574
ER -