Use of a three-dimensional custom-made porous titanium prosthesis for mandibular body reconstruction with prosthetic dental rehabilitation and lipofilling

Publication date: Available online 31 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Gaoussou Toure, Emmanuel Gouet

Abstract

Reconstruction of mandibular substance loss by free flap is a widely used technique. This technique suffers from several disadvantages; these include the presence of a second intervention site and a significant frequency of complications. We have undertaken a custom-made three-dimensional reconstruction (using CAD/CAM) with prosthetic dental rehabilitation and esthetic improvement by lipomodelling of the face. A fifty-year-old woman presented with a massive recurrence of an ameloblastoma of the right hemimandible. A cervical approach was used to resect the mandible well away from the tumor site. In light of her refusal to undergo reconstruction by fibula free flap, reconstruction was performed using a custom-made porous titanium device with dental prosthetic rehabilitation followed by lipomodelling of the face. The reconstruction was achieved without the occurrence of any complications. The implant-supported prosthetic dental implantation and the lipofilling resulted in functionally and esthetically satisfactory outcomes. Three-dimensional mandibular reconstruction with a custom-made porous titanium device and lipofilling yielded satisfactory results. Fitting of the dental prosthesis was undertaken at an early stage as it did not require osteointegration, although there was a need to overcome difficulties linked with the seal and the stability of the dental prosthesis and the titanium support. The duration of patient follow-up was 18 months.

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