Prosthetic rehabilitation of segmental mandibulectomy patient using a free fibula flap and Corticobasal implant supported prosthesis: A Case report.

INTRODUCTION

Segmental mandibular reconstruction using free fibula flaps and implants is challenging for maxillofacial surgeons and prosthodontists. This case report describes the successful use of Corticobasal implant reconstructive prostheses after a free fibula flap with five years of follow-up.

CLINICAL CASE PRESENTATION: A 24-year-old female presented to the clinic following segmental defect reconstruction using fibula reconstruction, owing to squamous cell carcinoma resection and seeking prosthetic treatment. An intraoral examination revealed a complete healing of the soft tissue. A panoramic radiograph showed a fibula bone graft rehabilitating the left side of the mandible supporting with a reconstructive plate. A multidisciplinary team was formed. A treatment plan included a mandibular reconstructive fixed Corticobasal implant prosthesis supported by eight basal cortical screw implants (BCS®, Dr. Ihde Dental AG, Switzerland) and a follow-up schedule was formulated. After 5-years of function, the implant demonstrated a 100 % survival rate, with no implant loss or fracture, excellent peri-implant soft tissue health, complete union of the bone graft, and a very stable prosthesis. The patient reported significant improvements in aesthetics, mastication, phonation, and self-satisfaction.

DISCUSSION: The multidisciplinary team has significantly improved the treatment outcomes. The prescribed treatment modality provides the patient with a fixed treatment modality, immediate loading, reduces the risk of biological and biomechanical complications, and hence improves the patient's functions and satisfaction.

CONCLUSION

A Corticobasal implant-supported prosthesis can be used in combination with a free fibula flap to reconstruct segmental mandibulectomy patients with a high survival rate and satisfactory aesthetic and functional outcomes.