Maxillary reconstruction using tunneling flap technique with 3D custom-made titanium mesh plate and particulate cancellous bone and marrow graft: a case report

Abstract

BackgroundReconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model.Case presentationThe patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure.ConclusionWe have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

Patient-specific plate for navigation and fixation of the distal radius: a case series

“…These reported residual errors are comparable with those we found in our study (TTE = 3.1 mm, TRE = 8.3°). Titanium PSPs have been 3D printed for a multitude of clinical applications, including reconstructive surgery of the skull [34], orbital floor [35], mandibula [36], maxilla [37], sternum [38], acetabulum [39], radius and ulna shaft [25], and distal radius [16,24,25]. Comparing the positioning results in applicable studies is often difficult since different evaluation parameters and dimensions are used to quantify the residual positioning error.…”

Titanium mesh and pedicled buccal fat pad for the reconstruction of maxillary defect: case report

“…In the case of maxillary anterior alveolar bone defect, custom-made titanium mesh combined with bone graft is a good option for reconstruction [ 4 ]. However, custom-made titanium mesh combined with bone grafts can be performed in cases with sufficient soft tissue coverage.…”

“…It is widely used because it has advantages such as rich vascularity, proximity to the recipient site, technical simplicity, and high success rate [1,2]. Other methods for the reconstruction of maxillary defects are free skin graft, buccal advancement flap, palatal pedicled flap, and microvascular flap [3,4].…”

Correction of facial asymmetry using a patient-specific three-dimensional printed polycarprolactone/beta tricalcium phosphate scaffold: a case report

“…Further, it allows the surgical objective to be determined preoperatively. This helps to reduce the operating time and improves surgical results [8].…”