Background and objectives: According to the literature the gold standard for mandibular reconstruction of large defects is the fibula free flap. The use of virtual planning and 3D model has allowed more accurate preoperative planning, but there are many difficulties to reproduce it during the surgery. In this work we propose a proper method for verifying and transferring the data of the preoperative planning by surgical navigation.

Materials and methods: 8 cases were treated at our O.U. The procedure consists in: elaboration of patient’s CT DICOM data, virtual simulation of the mandibular resection and reconstruction by fibula; an STL model was performed for shaping the reconstruction plate (STL) and then, we acquire the plate position by the navigator and we reproduce it on the surgical field before the resection phase.

Results: Morphological and functional outcomes are optimal and the occlusion is preserved in all cases. Thanks to our method we had more or less 90–120 min reduction in surgery time.

Conclusion: Thanks to our experience in orbital surgical navigation, we performed a strategy to navigate the mandible. Actually we routinely use our technique thanks to the optimal results and the high accuracy of the method.