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The Implant-borne Articulation Splint in Fibula Free Flap Mandibular Reconstruction: A Technical Note
Daniel C Sukato1, Rhorie Kerr2, Tara Aghaloo3
1Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland.
The Journal of Craniofacial Surgery
|October 6, 2023
Summary
This study introduces an implant-borne articulation splint to maintain precise implant and fibula graft positioning during maxillomandibular reconstruction. This technique improves accuracy in complex dental implant surgeries following fibula free flaps.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials Engineering
- Digital Dentistry
Background:
- Computer-aided design (CAD), computer-aided manufacturing (CAM), and digital surgical simulation have transformed maxillomandibular reconstruction.
- These technologies enhance accuracy and streamline dental implant placement in fibula free flaps.
- A translational gap between virtual planning and intraoperative measurements can compromise implant and graft orientation, particularly during fibula insetting.
Purpose of the Study:
- To present an advanced prosthodontic technique, the implant-borne articulation splint, designed to ensure stable graft and implant positioning during the final stages of maxillomandibular reconstruction.
- To demonstrate the clinical application and efficacy of this technique in maintaining a restorable position for fibula grafts and endosteal implants.
Main Methods:
- A case presentation detailing the technique and workflow of the implant-borne articulation splint.
- Utilizing virtual surgical planning, fibula free flap reconstruction, and endosteal implant placement.
- Postoperative and postradiotherapy assessment at 4 months.
Main Results:
- The implant-borne articulation splint effectively maintained the planned positions of fibula grafts and dental implants throughout the insetting procedure.
- The case demonstrated successful restoration at 4 months postoperative and postradiotherapy, indicating the splint's potential to preserve reconstructive precision.
Conclusions:
- The implant-borne articulation splint is a pivotal technique for ensuring optimal implant restorability in complex maxillomandibular reconstructions.
- Further research with larger studies is necessary to evaluate the cost-effectiveness and long-term outcomes of this innovative prosthodontic approach.
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