Mandibular Reconstruction Using a Customized Three-Dimensional Titanium Implant Applied on the Lingual Surface of the Mandible

Abstract

A patient had a right mandibular defect due to resection of an ameloblastoma. Previously, the defect had been reconstructed by an iliac bone graft, and subsequently, a titanium mesh with xenograft was used. However, it was not successfully reconstructed. For the recovery of mandible continuity and rehabilitation of jaw movement, we manufactured a customized 3-dimensional titanium implant by computer-aided design and manufacturing and electron beam melting technology. This implant was designed to have a porous body structure and lingual plate. The customized implant was accurately inserted in the bony defect. As a result, the patient showed a normal range of mouth opening and jaw movement. New bone migration was observed in the porous structure of the implant. Although there was a slight plate exposure and lack of alveolar bone formation, the customized 3D titanium implant successfully reconstructed the mandibular discontinuous defect and recovered jaw movement.

Wide Excision with Immediate Reconstruction of the Mandible Using Free Fibular Flap in Ameloblastoma of the Mandible—A Need of Time: Our Experience of 37 Cases

“…The proper selection of reconstructive modality is equally important for a favorable outcome. Metal plate, 37 bioimplant containing BMP-7, 38 distraction osteogenesis, 39 and osseous flaps are few of the options available for reconstruction. Metal plate fixation 40 is a simpler substitute where the microvascular facility is not available or when a patient's medical condition does not permit long hours of surgery.…”

Mandibular reconstruction using customized three-dimensional titanium implant

“…1 ) [ 4 , 5 ]. The designed implant was manufactured using an A1 metal 3D printer (Arcam, Molndal, Sweden) [ 6 ], with a biocompatibility material (Ti-6AL-4V-ELI medical grade powder) which is composed of titanium, aluminum, and vanadium [ 7 ].…”

Mandibular Body Reconstruction Utilizing a Three-Dimensional Custom-Made Porous Titanium Plate: A Four-Year Follow-Up Clinical Report

“…The recommended technique for mandibular reconstruction is the pedicled flap plus a titanium megaplate [2]. Although this method offers the filling tissue required and specific support, distinct limitations have been described: the establishment of a new surgical place, megaplate exposure or fractures, complications with the articulation, and several esthetic consequences [3][4][5]. Recently, three-dimensional (3D) custom-made porous titanium plates have been used for mandibular reconstructions, which offer an alternative in those cases of free flap contraindications or refusal by the patient; however, only very short-term follow-ups have been reported.…”