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Functional Reconstruction in Mandibular Avulsion Injuries

Leiser, Yoav DMD, PhD; Shilo, Dekel DMD, PhD; Wolff, Amir DMD; Rachmiel, Adi DMD, PhD

doi: 10.1097/SCS.0000000000003104
Clinical Studies

The present report describes the planning and surgery as well as pitfalls and management of a patient with a near total mandibular avulsion injury that was rehabilitated using three-dimensional (3D) laser printing of a titanium lower jaw. Laser-sintering involves zapping layers of powdered metal to recreate a 3D implantable skeletal defect. The process involves using either mirror imaging of the unaffected side or using archival image database of healthy individuals. A 25-year-old man presented with a gunshot injury that left him with a near total avulsed mandible. The patient received state-of-the-art treatment using a laser 3D printed mandible which was connected to the muscles of mastication for functionality. The inner side of the titanium jaw was filled with the patient's comminuted fractured bones in addition to harvested iliac crest bone graft that was covered with the patient's remaining periosteal tissue. The implantation of a near total mandible using 3D laser printing is a fast and predictable process that in selected patients can result in aesthetically as well as functionally excellent results. The authors believe that the future of craniofacial reconstruction will employ these methods for facial bony reconstruction.

*Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus

Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Address correspondence and reprint requests to Dekel Shilo, DMD, PhD, Rambam Health Care Campus, 8 Ha’Aliyah Street, Haifa 35254, Israel; E-mail:

Received 27 June, 2016

Accepted 16 July, 2016

The authors report no conflicts of interest.

© 2016 by Mutaz B. Habal, MD.