## 3 Results  
A total of 14 patients aged 8-17 years old (10 male, 4 female) were enrolled in the study. All patients underwent mandibularomy (ramus and body n = 12; ramus only n = 2) with immediate 3D-assisted TMJR supported by microvascular free flap reconstruction (FFF or ICFF) (Table 1). Figure 2: Intraoperative photographs showing examples of: (**a**) medial mandible resection template; (**b**) iliac graft harvesting template; (**c**) fibular graft harvesting template; and (**d**) intraoperative view of the graft (blue arrow) connected to the customized prosthesis and reconstruction plate (green) before fixing. \begin{table}
\begin{tabular}{l c c c c c c c c c} \hline
**Gender** & **Age [Year]** & **Diagnosis** & **Malignancy** & **Mandibulectomy** & **TMJ** & **Reconstruction** & **Follow-Up** & **Additional** & **Final Treatment** \\  & & & & & & & & & & \\  & & & & & & & & & & \\ \hline Male & 8 & Fibroma Cosilicians & Benign & Ramus only & Unilateral & ICFF & 5 & None & Ordodontic \\ \hline Male & 8 & Fibrous Displasia & Benign & Ramus only & Unilateral & ICFF & 5 & None & Ordodontic \\ \hline Female & 10 & Sarcoma & Cancer & Ramus \& Body & Unilateral & FFF & 4 & None & Ordodontic \& Dental Implants \\ \hline Male & 11 & Sarcoma & Cancer & Ramus \& Body & Unilateral & FFF & 6 & None & Ordodontic \\ \hline Female & 12 & Severe Deformation & Benign & Ramus \& Body & Bilateral & FFF & 4 & Ordopathic & Ordodontic \\ \hline Male & 13 & Fibrous Displasia & Benign & Ramus \& Body & Bilateral & FFF & 2 & None & Ordodontic \\ \hline Male & 13 & Severe Deformation & Benign & Ramus \& Body & Unilateral & FFF & 5 & Orthopathic & Ordodontic \& Dental Implants \\ \hline Male & 13 & Sarcoma & Cancer & Ramus \& Body & Unilateral & FFF & 5 & None & Ordodontic \\ \hline Male & 13 & Sarcoma & Cancer & Ramus \& Body & Unilateral & ICFF & 5 & Reconstructive & Ordodontic \& Dental Implants \\ \hline Male & 14 & Amelobstoma & Benign & Ramus \& Body & Unilateral & FFF & 4 & None & Ordodontic \& Dental Implants \\ \hline Male & 15 & Fibrous Displasia & Benign & Ramus \& Body & Unilateral & FFF & 2 & None & Ordodontic \\ \hline Female & 15 & Amelobstoma & Benign & Ramus \& Body & Unilateral & FFF & 5 & Reconstructive & Ordodontic \& Dental Implants \\ \hline Female & 17 & Amelobstoma & Benign & Ramus \& Body & Unilateral & ICFF & 5 & Ordopathic & Ordodontic \& Dental Implants \\ \hline Male & 14 &
\begin{tabular}{c} Central Cell Giant \\ Granuloma \\ \end{tabular} & Benign & Ramus \& Body & Unilateral & FFF & 4 & None & Ordodontic \& Dental Implants \\ \hline \end{tabular}
\end{table} 
Table 1: Summary of patients enrolled in the study, including: diagnosis, level of malignancy, resection extent, and reconstruction type. Additional surgery performed after the follow-up (2-6 years postoperatively): none—orthodontic treatment and implant placement were performed with use of a primary graft after the follow-up; reconstructive—orthodontic treatment and implant placement required secondary bone grafting: orthogathistic—additional orthogathistic surgery was required in order to treat skeletal deformation at the time of the TMRJ surgery or after the follow-up. Ten patients were operated on due to benign diseases: ameloblastoma (n = 3), fibrous dysplasia (n = 3), central giant cell tumor (n = 1), and fibroma ossificans (n = 1). Mandibulectomy with TMJ was performed due to sarcoma in four patients and due to congenital deformations in two patients: one due to congenital deformations (hemifacial macrosomia) and one for acquired ankylosis of the TMJ. The vast majority of cases were treated with an FFF graft (n = 11) (\(p<0.005\)). Unilateral defects requiring surgical intervention were the most common (\(p<0.005\)). Only two patients required bilateral surgery (also performed immediately): one due to fibrous dysplasia and the other due to severe deformation. In the group of patients operated on unilaterally, mandible growth was evaluated.