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Use of a 3-Dimensional Custom-Made Porous Titanium Prosthesis for Mandibular Body Reconstruction With Prosthetic Dental Rehabilitation and Lipofilling

Published:December 31, 2018DOI:https://doi.org/10.1016/j.joms.2018.12.026
      Reconstruction of mandibular substance loss by a free flap is a widely used technique. This technique suffers from several disadvantages, including the presence of a second intervention site and a substantial frequency of complications. We have undertaken a custom-made 3-dimensional reconstruction (using computer-aided design and manufacturing) with prosthetic dental rehabilitation and esthetic improvement by lipomodeling of the face. A 50-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 a fibula free flap, reconstruction was performed using a custom-made porous titanium device with dental prosthetic rehabilitation, followed by lipomodeling 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 osseointegration, although there was a need to overcome difficulties linked with the seal and the stability of the dental prosthesis and titanium support. The duration of patient follow-up was 18 months.
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