Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma

Odin, Guillaume; Balaguer, Thierry; Savoldelli, Charles; Scortecci, Gérard M.

doi:10.1563/aaid-joi-d-09-00031

Cited by 21 publications

(10 citation statements)

References 4 publications

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“…As recently as 2010, immediate implant placement in reconstruction following ablation of a squamous cell carcinoma was case reportable. 29 We feel that the use of computer-aided design/computer-aided manufacturing technologies as described facilitated dental reconstruction in a number of ways. First, planning allows preoperative consideration of three-dimensional flap positioning.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Virtually Planned Free Fibula Flap Reconstruction of the Mandible

Avraham

Franco

Brecht

et al. 2014

Plastic and Reconstructive Surgery

155

108

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Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Virtually Planned Free Fibula Flap Reconstruction of the Mandible

Avraham

Franco

Brecht

et al. 2014

Plastic and Reconstructive Surgery

155

108

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“…An alternative is to place the implants in the fibula, make an impression or optical scan, and deliver a laboratory-fabricated provisional prosthesis 48 hours later. 7 Our technique of in-house 3D printing eliminates the delay of waiting the additional time for fabrication of the dental prosthesis. In our experience, the prosthesis is 3D printed well before the custom plate and models will arrive from the vendor, usually within 24 hours of the VSP session.…”

Section: Discussionmentioning

confidence: 99%

Immediate Teeth in Fibulas: Planning and Digital Workflow With Point-of-Care 3D Printing

Williams

Hammer

Wentland

et al. 2020

Journal of Oral and Maxillofacial Surgery

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Point-of-care 3-dimensional (3D) printing has become more common in recent years because many hospitals have created 3D printing laboratories. Traditional techniques to fabricate an immediate dental prosthesis for fibula and implant reconstructions have involved outsourcing to dental laboratories. This results in delays, making it suitable only for benign disease. In the present report, we have demonstrated a technique for in-house creation of a 3D printed dental prosthesis for placement of implants at free fibula maxillofacial reconstruction. Our digital method has reduced costs and shortened the interval to surgery compared with traditional laboratory techniques. Materials and Methods: Twelve patients underwent free fibula reconstruction of the mandible or maxilla with immediate implants and immediate teeth. A dental implant-retained restoration was created before surgery for immediate placement at fibula reconstruction. For the first 5 patients, the prosthesis was fabricated by a dental laboratory after virtual surgical planning. For the next 7 patients, the prosthesis was designed by the surgeon and 3D printed via the in-house laboratory. Four of these in-house cases were performed for malignant disease with skin paddles. Results: All 12 patients received an immediate implant-retained fixed prosthesis at fibula reconstruction. The time required to generate the in-house 3D printed prostheses was significantly shorter than that required to create the dental laboratory-fabricated prostheses. The costs were also less with the 3D printed prostheses compared with the dental laboratory-fabricated prostheses. Conclusions: The digital workflow we have presented eliminates the delay in creating a dental laboratory-fabricated provisional dental prosthesis for fibula and implant reconstruction. This allows for immediate dental restoration for patients with malignant disease previously considered unsuitable owing to the inherent delay required using an offsite dental laboratory. A decrease in cost to create in-house 3D printed prostheses was noted compared with the prostheses fabricated by a dental laboratory. Case selection is critical to predict the soft tissue needs for composite defects.

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“…Some reports indicate that immediate functional implant and screw-secured fixed prosthesis serve as an external fixator for the implants and grafted bone. 11,12 However, we started occlusal rehabilitation with implant insertion after 14 months. During this period, continuous reduction of the vertical dimension and flattening of the mandibular angle might continue to occur.…”

Section: Discussionmentioning

confidence: 99%

Sagittal Split Osteotomy on the Previously Reconstructed Mandible With Fibula Free Flap

Kim¹,

Lee²,

Kwon³

2014

Journal of Craniofacial Surgery

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The fibula free flap offers several advantages in mandibular reconstruction, including an optimal length and bone quality for dental implantation; therefore, the use of this flap has become a method of choice for mandibular reconstruction. Although the development of computer-assisted surgical planning has increased the accuracy of mandibular reconstruction, some unexpected outcomes still occur in clinical settings. The patient in this report underwent mandibular reconstruction with the fibula free flap because of mandibular resection resulting from an ameloblastoma. However, unexpected movement of the grafted fibula bone had been observed, and we could not achieve a proper occlusal relationship even with implant-supported prosthesis. To resolve this problem, we corrected the position of previously grafted fibula and implants by using orthognathic surgery: sagittal split osteotomy on body and angle area and vertical osteotomy on the mandibular symphysis. After the orthognathic surgery at the previously reconstructed mandible with fibula free flap, a favorable and stable occlusal relationship could be achieved. The result demonstrated that the sagittal split osteotomy at the previous fibula free flap site can be successfully carried out to establish the proper occlusion.

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Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma

Cited by 21 publications

References 4 publications

Functional Outcomes of Virtually Planned Free Fibula Flap Reconstruction of the Mandible

Functional Outcomes of Virtually Planned Free Fibula Flap Reconstruction of the Mandible

Immediate Teeth in Fibulas: Planning and Digital Workflow With Point-of-Care 3D Printing

Sagittal Split Osteotomy on the Previously Reconstructed Mandible With Fibula Free Flap

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