Jaw in a day: total maxillofacial reconstruction using digital technology

Plast Reconstr Surg. 2013 Jun;131(6):1386-1391. doi: 10.1097/PRS.0b013e31828bd8d0.

Abstract

Background: Tumors of the mandible are complex, often requiring replacement of bone, soft tissue, and teeth. The fibula flap has become a routine procedure in large tumors of the jaw, providing bone and soft tissue at the time of the resection. In current practice, dental reconstruction is delayed for 3 to 6 months, leaving the patient without teeth in the interim. This can be disfiguring and anxiety provoking for the patient.

Methods: In this article, the authors present three patients with benign tumors of the mandible who underwent virtually guided resection, fibula reconstruction, and insertion of an implant-retained dental prosthesis in one operation. In addition, the authors report their early experience using this technique in the maxilla.

Results: The authors present a case series of three patients with benign mandibular tumors and one patient with a benign maxillary tumor who underwent total reconstruction using computer-aided design and computer-aided manufacturing technology in a single stage.

Conclusions: In the right situation, total mandibular reconstruction is possible in a single stage. This is demonstrated by the successful outcomes of these patients.

Clinical question/level of evidence: Therapeutic, V.

MeSH terms

  • Bone Plates*
  • Computer Simulation
  • Computer-Aided Design*
  • Dental Prosthesis, Implant-Supported
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Mandibular Neoplasms / diagnosis
  • Mandibular Neoplasms / surgery*
  • Mandibular Prosthesis*
  • Mandibular Reconstruction / methods*
  • Maxillary Neoplasms / diagnosis
  • Maxillary Neoplasms / surgery*
  • Maxillofacial Prosthesis*
  • Microsurgery / methods*
  • Prosthesis Design
  • Prosthesis Fitting
  • Software*
  • Surgery, Computer-Assisted / methods*
  • Surgical Flaps / blood supply*
  • Surgical Flaps / surgery*
  • User-Computer Interface