Virtual Surgical Planning and Customized Subperiosteal Titanium Maxillary Implant (CSTMI) for Three Dimensional Reconstruction and Dental Implants of Maxillary Defects after Oncological Resection: Case Series.
Jose Luís Cebrián Carretero, José Luis Del Castillo Pardo de Vera, Néstor Montesdeoca García, Pablo Garrido Martínez, Marta María Pampín Martínez, Iñigo Aragón Niño, Ignacio Navarro Cuéllar, Carlos Navarro Cuéllar
Author Information
Jose Luís Cebrián Carretero: Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
José Luis Del Castillo Pardo de Vera: Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
Néstor Montesdeoca García: Oral and Maxillofacial Surgery Department, Hospital La Luz, 28003 Madrid, Spain. ORCID
Pablo Garrido Martínez: Oral and Maxillofacial Surgery Department, Hospital La Luz, 28003 Madrid, Spain. ORCID
Marta María Pampín Martínez: Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
Iñigo Aragón Niño: Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain. ORCID
Ignacio Navarro Cuéllar: Oral and Maxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, Spain. ORCID
Carlos Navarro Cuéllar: Oral and Maxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, Spain. ORCID
Maxillectomies cause malocclusion, masticatory disorders, swallowing disorders and poor nasolabial projection, with consequent esthetic and functional sequelae. Reconstruction can be achieved with conventional approaches, such as closure of the maxillary defect by microvascular free flap surgery or prosthetic obturation. Four patients with segmental maxillary defects that had been reconstructed with customized subperiosteal titanium maxillary implants (CSTMI) through virtual surgical planning (VSP), STL models and CAD/CAM titanium mesh were included. The smallest maxillary defect was 4.1 cm and the largest defect was 9.6 cm, with an average of 7.1 cm. The reconstructed maxillary vertical dimension ranged from 9.3 mm to 17.4 mm, with a mean of 13.17 mm. The transverse dimension of the maxilla at the crestal level was attempted to be reconstructed based on the pre-excision CT scan, and these measurements ranged from 6.5 mm in the premaxilla area to 14.6 mm at the posterior level. All patients were rehabilitated with a fixed prosthesis on subperiosteal implants with good esthetic and functional results. In conclusion, we believe that customized subperiosteal titanium maxillary implants (CSTMI) are a safe alternative for maxillary defects reconstruction, allowing for simultaneous dental rehabilitation while restoring midface projection. Nonetheless, prospective and randomized trials are required with long-term follow-up, to assess its long-term performance and safety.
