Occlusal Reconstruction by Maxillary Bone Grafting, Dental Implants and Orthognathic Surgery After Facial Trauma

Facial and intraoral photographs. (a) Frontal and lateral photographs show symmetry, mandibular protrusion and a long face. (b) Intraoral photograph shows numerous missing teeth in the maxilla and vertical and horizontal deficiencies in the anterior maxillary alveolar ridge. Occlusion was an anterior open bite with the denture.

Lateral cephalogram. The lateral cephalogram shows a long face, maxillary retrusion, mandibular protrusion, and an open bite.

Computed tomography (CT) images. CT images show vertical and horizontal loss of alveolar bone around the anterior maxillary teeth. Top: Axial cross-section. Bottom: Sagittal cross-section.

The custom-made Ti-mesh tray on the 3D skull model. The custom-made Ti-mesh tray was fabricated preoperatively using a life-sized, 3D skull model. The ideal alveolar ridge for occlusal reconstruction was built up with dental wax over the anterior maxillary defect in the 3D model. A Ti-mesh sheet was then cut and formed according to this model.

Panoramic radiograph after dental implant placement. Five implants were placed in the anterior maxillary region, and the placement site, orientation, and depth were good.

Facial and intraoral photographs 5 years after the start of implant loading and 2 years after jaw deformity surgery. (a) Facial photographs. (b) Intraoral photographs.