Fully Digital Workflow for an Osteoma in Proximity to the Inferior Alveolar Nerve by a 3D-Printed Surgical Guide and Piezosurgery: A Case Report

Mandibular osteoma is a benign bone tumour that is frequently discovered incidentally during a routine radiographic examination. Surgical management may be challenging when the lesion is located close to the inferior alveolar nerve, due to the potential risk of neurological complications. This case report describes the management of an intraosseous osteoma of the right posterior mandible in a 47-year-old woman. Given the intimate relationship between the lesion and the inferior alveolar nerve, a fully digital workflow was adopted to optimize surgical planning and enhance intraoperative safety. A patient-specific 3D-printed surgical guide was designed to define the osteotomy using piezoelectric surgery accurately and to facilitate precise bone cutting, minimizing the risk of injury to adjacent neurovascular structures. Histopathological examination confirmed the diagnosis of osteoma. This case highlights the advantages of combining digital guided surgery and piezoelectric bone surgery to increase surgical precision and minimize the risk of nerve injury. In this case, the combined use of digital guided surgery and piezoelectric bone surgery facilitated precise surgical access while supporting preservation of the adjacent neurovascular structures.