Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma
The authors describe a case of squamous cell carcinoma of the oral cavity managed by ablative surgery, mandibular reconstruction with a fibula free flap, and implant placement during the same session. Immediate functional implant loading, respecting the principles of basal implantology, was performed 48 hours later using a highly rigid, screw-secured fixed prosthesis that served as an external fixator for the implants and grafted bone. Implant loading before external beam radiotherapy improves flap stability, bone consolidation, and quality of life. Functional and esthetic outcomes were evaluated 2 years after radiotherapy was completed.Abstract
Figure 1 . Intraoral view prior to surgery. Figure 2. Resected surgical specimen. Figure 3. Fibula free flap preparation. Figure 4. Fibula free flap shaped and maintained by osteosynthesis plates.
Figure 5 . Panoramic view after implantation. Figure 6. Plate-form Diskimplants.
Figure 7 . Screw-secured, machined titanium/cobalt-chromium/resin fixed prosthesis. Figure 8. Intraoral view after 2 years of function. Figure 9. Fusion of the grafted fibula blocks to the remaining ramus. Figure 10. Close-up view of an implant. Figure 11. Cosmetic outcome after 2 years.
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