Virtual surgical planning and 3d simulation with augmented reality in mandibular monostotic fibrous dysplasia

a case report

Resumen

Monostotic fibrous dysplasia (MFD) is a benign, non-hereditary skeletal disorder characterized by the replacement of normal bone with fibrous tissue and immature woven bone. Although the craniofacial region is frequently affected, mandibular involvement is less common and may pose significant clinical and surgical challenges, particularly in recurrent or symptomatic cases. This case report describes a patient with mandibular MFD presenting lesion progression and persistent neuropathic pain following initial surgery. A second surgical intervention was subsequently performed using advanced digital technologies, including virtual surgical planning, 3D modeling and printing, intraoperative simulation guided by augmented reality, and customized cutting guides. Postoperative computed tomography confirmed high fidelity to the surgical plan and improvement in facial symmetry. This case highlights important advances in the application of digital technologies in oral and maxillofacial surgery, demonstrating increased precision, improved aesthetic outcomes, and enhanced anatomical preservation. To our knowledge, this is one of the few documented cases of recurrent mandibular fibrous dysplasia treated using digital surgical simulation and multiplanar cutting guides. These findings suggest that virtual planning and augmented reality may become valuable tools in the management of complex craniofacial bone lesions, increasing predictability and patient satisfaction while minimizing risks in revision surgeries.