(75) Primary Facial Reconstruction With the Use of Customized Titanium Implant

Abstract: Primary facial reconstruction after tumor resection has been a major challenge, especially larger ones, also due to the complex and irregular morphology of the human face. Several techniques have been proposed using CAD-CAM technology for this purpose. Among these, the use of customized plates associated or not with microvascularized free grafts has gained prominence. However, several problems were highlighted with its use, such as long surgical times, need for a donor area and greater morbidity, difficulty in adapting the graft to the recipient area due to differences in bone length/thickness. It also requires long training time for the care team, in addition to contraindications related to the patient, such as previous cervical surgery, atherosclerotic peripheral arterial disease in
We are going to present a step-by-step case for facial customized titanium prosthesis reconstruction. The first step are image acquisitions, followed by digital planning and printing of biomodels, followed by printing the surgical guides and final prosthesis, with CAD-CAM technology. The partial results will be discussed. The accuracy was satisfactory; Nonetheless, was noted prosthesis extrusion and infection. Considerations about adjuvant procedures, such as the use of plasma rich-platelet and laser therapy can improve the outcomes.
The use of surgical guides for the osteotomiesLarge bone defect immediatly after tumor ressection Facial titanium prosthesis adapted to the defect