A new implant for nasal reconstruction.

Extraoral implants have been used for many years to anchor silicone nasal prostheses. This report describes the design and use of a specially engineered bifunctional implant, which is placed via an intraoral approach, to simultaneously anchor nasal and oral prostheses for an edentulous patient who has undergone a complete rhinectomy. The bifunctional implant was designed and milled from commercially pure titanium using computer-aided design/computer-assisted manufacturing (CAD/CAM) technology. The nasal part of the implant was designed to fit through the prepared site and protrude into the piriform aperture. A hex attachment was orientated perpendicular to the axis of the implant on this extension. The intraoral head of the implant was provided with a standard Branemark hex configuration. Implants were placed using the guide and associated instrumentation. This case demonstrates the potential for CAD/CAM technology to produce bespoke implantable components at low cost. In this report, the implant greatly facilitated the surgical and prosthetic management for the simultaneous provision of nasal and oral prostheses.