Facial and oral reconstruction following trauma and failed chin implant: a case report.

Functional and esthetic reconstruction of a patient with microgenia who sustained traumatic injury was successfully accomplished using Brånemark System osseointegrated implants (Nobel Biocare USA, Inc., Yorba Linda, CA) to support a permanent dental prosthesis following mechanical and biologic reconstruction of the anterior mandible and chin. A 25-year-old glycine chin implant previously used for facial esthetic enhancement had eroded the anterior cortical plate and migrated through the medullary bone, compressing the periosteum into the apex of the anterior tooth roots. Further destruction of the lingual cortex with risk of fracture was imminent. After removal of the chin implant, a cancellous bone graft was held in place with a titanium mesh frame. The prosthetic rehabilitation consisted of two phases of mandibular implant placement followed by the construction of a porcelain-fused-to-gold implant-supported fixed prosthesis, restoring the occlusal vertical dimension as well as appropriate lip support. Restoration of function was superior to the pretreatment condition.