Objective <p>To explore the clinical value of three-dimensional digital technology and 3D-printed surgical guides in the treatment of pediatric mandibular fractures with transitional dentition. At the same time, focus on the fixed dentition defects in children, jawbone development, and the protection of permanent tooth germs.</p> Methods <p>This case series reviewed three pediatric patients with mandibular fractures in the mixed dentition period, presenting with varying injury severity. For each case, CT data were utilized to create three-dimensional digital models of the jawbone, deciduous dentition, and tooth buds. A virtual reduction was performed to restore the occlusal relationship, followed by the digital design of patient-specific occlusal splints. Both the splints and the corrected jaw models were then 3D-printed and used intraoperatively to guide precise reduction and fixation. Postoperative outcomes were assessed through clinical follow-up, and the results were contextualized with a review of the relevant literature.</p> Results <p>Postoperative follow-up showed good healing of the mandibular fracture, with no impact on mandibular development and the tooth germs are undamaged. The postoperative occlusal relationship was satisfactory.</p> Conclusion <p>The use of computer-aided three-dimensional digital technology and 3D printing technology, based on CT data for occlusal reconstruction, assists in the accurate reduction of mandibular fractures and minimizes the impact on mandibular development and tooth germ eruption. The demonstrated workflow establishes a valuable and reliable technique for the treatment of mandibular fractures in children, offering a significant advantage in preserving long-term function and growth.</p>