Oral Rehabilitation With Clear Aligners and Implant-Supported Prosthetic Restorations After Mandibular Reconstruction...

This case report presents the complex orthodontic and prosthetic rehabilitation process of a 30-year-old man who presented to our clinic seeking to restore chewing function and aesthetics following radical surgical resections for mandibular osteosarcoma. His oncological history included a tumor infiltrating the right mandibular ramus and corpus. Archived radiographic data indicated that this lesion was locally invasive and exhibited an aggressive bone destruction pattern, so the patient initially underwent a segmental mandibulectomy. However, due to positive surgical margins, subsequent extensive resections were performed. The resulting extensive defect, which included the surrounding soft tissues, was stabilized with a titanium reconstruction plate. The current clinical evaluation revealed a significant extraoral contour defect secondary to previous surgeries, complete edentulism of the mandible, and dental malpositions in the maxillary arch. Although the patient had a skeletal Class II (ANB: 5.1 degrees) anomaly, the profile convexity was acceptable. Accordingly, a multidisciplinary treatment plan was implemented in 2 main phases. In the first phase, orthodontic treatment with clear aligners (Invisalign) was applied to align the teeth in the maxillary arch to their ideal positions. Following the completion of the orthodontic phase, the second phase provided functional and aesthetic restoration for the reconstructed edentulous mandible with an implant-supported fixed prosthesis. This case is a powerful example of how multidisciplinary collaboration can provide predictable and patient-centered solutions, even in the most challenging cases. Clinicians should consider clear aligners as a reliable treatment option in such complex cases.