Expanding use of osseointegrated implantation using 3-dimensional surgical planning: a paradigm shift in dental reconstruction

摘要

Medical modeling and 3-dimensional (3D) virtual surgical planning represent a rapidly expanding, technological advancement especially useful in complex mandibular or maxillary defects in head and neck reconstruction. With utilization of 3D surgical planning, the reconstructive surgeon can initiate dental rehabilitation during the primary surgery with osseointegrated implants (OI), streamlining a typically lengthy process to full oral rehabilitation. Careful patient selection is important to optimize outcomes with immediate OI, and factors to consider during the evaluation process include pathology, prognosis, anticipated defect, dental status, donor site availability, and patient motivation and resources. Synthesizing this information and developing a reconstructive plan with a multidisciplinary team approach is critical to expedite dental rehabilitation for select patients. A review of relevant literature and our surgical planning algorithm for selecting candidates for immediate OI is provided, along with our experience using this decision algorithm in a uniquely complex clinical case.