Ten-year evolution utilizing computer-assisted reconstruction for giant ameloblastoma.

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Biomedical Engineering

Background:

• Ameloblastomas, particularly giant types, often require aggressive surgical resection, leading to significant defects.
• Reconstruction of these defects presents challenges in restoring both form and function, including dental rehabilitation.

Purpose of the Study:

• To describe a comprehensive approach for reconstructing giant ameloblastomas using computer-aided virtual planning.
• To evaluate the outcomes of microvascular free tissue transfer with immediate implant and dental prosthesis placement.

Main Methods:

• A retrospective review of 20 patients with advanced ameloblastomas treated between 2001 and 2011.
• Reconstruction utilized osseocutaneous fibular free flaps.
• Computer-aided virtual planning was employed for pre-operative surgical simulation.

Main Results:

• 35% of patients experienced complications, with two complete flap failures requiring revision.
• 16 patients received endosteal implants for dental rehabilitation.
• Immediate implant placement at the time of free flap reconstruction was performed in nine patients, with the three most recent also receiving immediate prostheses.

Conclusions:

• Computer-aided virtual planning enhances microvascular free flap reconstruction for giant ameloblastomas.
• Simultaneous free flap reconstruction with immediate dental implant and prosthesis placement is a viable option for comprehensive rehabilitation.