Official websites use. Share sensitive information only on official, secure websites. Background: Head and neck reconstruction following ablative surgery results in alterations to maxillofacial anatomy and function. These postoperative changes complicate dental rehabilitation. Methods: An innovative modular, stackable guide system for immediate dental rehabilitation during mandibular reconstruction is presented.
The virtual surgical planning was performed in Materialise Innovation Suite v26 and Blender 3. The surgical guides and models were designed and manufactured at the point of care. Results: The duration of the surgery was 9 h and 35 min. After 9 months of follow-up, the occlusion remained stable, and a mouth opening of 25 mm was registered.
The dental implants showed no signs of peri-implant bone loss. Superposition of the preoperative planning and postoperative position of the fibula parts resulted in an average difference of 0. Conclusions: The in-house developed stackable guide system resulted in a predictive workflow and accurate results. The addition of fully guided implant placement to this stackable guide system would be beneficial. More research with longer follow-ups is necessary to validate these results.
Keywords: virtual surgical planning, 3D printing, additive manufacturing, in-house production, fibula free flap, oncologic reconstruction, dental rehabilitation, jaw-in-a-day. Extensive resections in the head and neck area significantly alter the facial and oral anatomy, often resulting in a shallow vestibule, lip incompetence, sensory disturbances, and trismus.
These anatomical changes significantly compromise the prosthetic retention possibilities, complicating rehabilitation with removable prostheses [ 2 ]. The use of dental implants as support for dental prostheses has facilitated oral rehabilitation in oral cancer patients. Primary implantation was an important first evolution [ 3 , 4 ]. However, this treatment plan typically involves multiple interventions, a long and multidisciplinary process whereby placement of dental implants does not always result in prosthetic rehabilitation.
