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Jaw in a Day: Total Maxillofacial Reconstruction Using Digital Technology

Levine, Jamie P. M.D.; Bae, Jin Soo D.D.S., M.D.; Soares, Marc M.D.; Brecht, Lawrence E. D.D.S.; Saadeh, Pierre B. M.D.; Ceradini, Daniel J. M.D.; Hirsch, David L. D.D.S., M.D.

Plastic and Reconstructive Surgery: June 2013 - Volume 131 - Issue 6 - p 1386–1391
doi: 10.1097/PRS.0b013e31828bd8d0
Pediatric/Craniofacial: Ideas and Innovations
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Discussion

Background: Tumors of the mandible are complex, often requiring replacement of bone, soft tissue, and teeth. The fibula flap has become a routine procedure in large tumors of the jaw, providing bone and soft tissue at the time of the resection. In current practice, dental reconstruction is delayed for 3 to 6 months, leaving the patient without teeth in the interim. This can be disfiguring and anxiety provoking for the patient.

Methods: In this article, the authors present three patients with benign tumors of the mandible who underwent virtually guided resection, fibula reconstruction, and insertion of an implant-retained dental prosthesis in one operation. In addition, the authors report their early experience using this technique in the maxilla.

Results: The authors present a case series of three patients with benign mandibular tumors and one patient with a benign maxillary tumor who underwent total reconstruction using computer-aided design and computer-aided manufacturing technology in a single stage.

Conclusions: In the right situation, total mandibular reconstruction is possible in a single stage. This is demonstrated by the successful outcomes of these patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Supplemental Digital Content is available in the text.

New York, N.Y.

From the Departments of Plastic Surgery, Oral and Maxillofacial Surgery, Microsurgery, and Maxillofacial Prosthodontics, New York University Medical Center; and Plastic Surgery, Manhattan Veterans Affairs Medical Center.

Received for publication August 10, 2012; accepted December 5, 2012.

Disclosure:None of the authors has any financial incentives or other conflicts of interest with the companies mentioned in this article.

Supplemental digital content is available for this article. A direct URL citation appears in the text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal’s Web site (www.PRSJournal.com).

Department of Plastic Surgery, New York University Langone Medical Center, 560 First Avenue, Suite TH169, New York, N.Y. 10016, jamie.levine@nyumc.org

©2013American Society of Plastic Surgeons