Background: Jaw reconstruction after complex post-traumatic fracture is still a challenge for surgeons using traditional surgery. Virtual surgical planning has proven to be a valid tool for managing these fractures. The aim of this study is to quantitatively evaluate the VSP effectiveness compared to traditional surgery in the management of complex mandibular fractures.

Methods: 30 patients with diagnosis of complex mandibular fracture were enrolled and divided in two groups: Group A (virtually planned surgery), The plate was pre-modeled and employed during the surgery; Group B (traditional surgery), the plate was shaped directly during the surgery. Virtually planned and post-operative Computer Tomography were after compared for both the groups to highlight discrepancies in mm.

Results: Fracture surgical reduction was successful without intraoperative complications. In Group A, all the mean discrepancies’ values were <1 mm while in Group B the values were included between 1.36 and 1.94 mm. The mean operative time was 69 min for Group A, while 106 min for Group B.

Conclusions: Fracture virtual reduction and realization of pre-modeled plate are able to guarantee a more anatomically correct reduction and a decrease in operating times. These outcomes translate into a decrease in both short and long-term complications.