The following 38-year-old non-smoking patient with no relevant medical history was referred to us. She had had three implants placed and following an infection, had lost two of them – leaving the defect visible in the photograph.
We considered the possibility of short implants or mandibular reconstruction plus the placement of standard implants. With the short implants, rehabilitation could be achieved with a fixed prosthesis, but there were 3 main disadvantages: disadvantageous lever arms, poor quality of soft tissues due to being very close to the floor of the mouth, and difficult hygiene.
We opted for reconstruction, as the patient was young, healthy and a non-smoker, which would enable us to place standard-sized implants, move further away from the floor of the mouth, and avoid disadvantageous lever arms. We effect a tunnel access, which would allow us to close the reconstruction without tension in the sutures and without compromising vascular supply of the periosteum as it would be intact, and three-dimensional reconstruction with Professor Khoury’s technique with completely autologous bone.
Below you can view photographs of the surgery; we have shown the tongue and the floor of the mouth in black and white so you can properly see the extent of the defect.
We hope it is interesting to you. You can see the follow-up of this case, with the implant surgery, here: Implants over 3D mandibular reconstruction