SupplementPoster 772, Language: German, EnglishKoch, Felix Peter / Fuchs, Olaf / Götze, E. / Schulz, P. / Moergel, M. / Wentaschek, S. / Wegener, J. / Wagner, W.
Introduction: Large defects oft he human face regularly occur after Head&Neck trauma or cancer resection. They often cause esthetic as well as functional disorders, especially if the dental arch is affected. For a esthetic and functional reconstitution 2-4 operations are necessary. We present a new technique providing the reconstruction of the mandible combined with prothodontic rehabilitation by a single operation .
Methode: The 58years old patient presented with a near total defect oft he mandible after cancer resection and primary reconstruction by a titanium plate which perforated the skin within the first year.
Aiming a complete reconstruction oft he mandible, the gingiva and the deeth, a 3D model oft he skull was manufactured and upper as well as lower jaw protheses. Positioning the mandibular joints in the centre of the fossae, four dental implants have been planned to provide a quatrangular base for the lower jaw prothesis. The position oft he fibula segments as well as their angulation and lengths were adapted to the implant position. After, the molded fibula, bearing already the dental implants has been transformed into its natural straight appearance again to design the sawing splint and the implants drilling guide. To provide the correct angulation of the fibula segments a CAD/CAM dental archbar was manufactured from Titanium. This new approach of an prefabrictaed archbar fulfills three function: 1. It bears the prothethis 2. It stabilizes the molded fibula as a fixateur externe 3 it positions the complete fibula with rhe prothesis in a correct relation to the upper jaw, indicated by the protheses.
Conclusion: This innovative approach of an prothodontic and reconstructive rehabilitation could shorten total reconstruction/rehabilitation time.
Keywords: CAD/CAM, microvascular fibula, cancer, reconstruction, 3D print