Restoring premorbid occlusal relationship with 3D-printed occlusal splints in treatment of extensive comminuted mandibular fractures: an exploratory technical report.

BACKGROUND: Extensive comminuted mandible (ECM) fractures with dentition defects pose challenges for occlusal restoration. In selected severe cases with extensive comminution and compromised dentition, conventional MMF may be difficult to apply effectively. This study aimed to evaluate the applicability and outcomes of using three-dimensional (3D) printed occlusal splints for occlusal restoration in ECM fractures.

METHODS: This retrospective, non-randomized cohort study with a small sample size was conducted involving 22 patients with ECM fractures. Twelve patients were treated with 3D-printed occlusal splints for occlusal restoration (Group A). The other 10 patients who received traditional maxillomandibular fixation (MMF) served as the control group (Group B). After confirming baseline comparability between groups, outcomes were quantitatively assessed using linear measurement deviation and 3D analysis, with fracture healing as the primary outcome measure.

RESULTS: Fracture healing was achieved in all patients. According to radiographic and clinical assessment (no validated occlusal index was used), all patients in Group A achieved the planned occlusal restoration. Compared to Group B, Group A demonstrated better reduction accuracy, reflected by significantly smaller deviations in both linear measurement deviation and 3D analysis (p < 0.05).

CONCLUSION: In this small retrospective cohort, 3D-printed occlusal splints provide a technical solution for occlusal restoration in selected severe cases of ECM fractures. This technique represents a promising adjunct but requires further validation in larger prospective studies.