Successful Secondary Reconstruction and Dental Rehabilitation for a Maxillary Bone Defect With Discontinuity After Partial Maxillectomy: A Case Report.

Abstract

Secondary reconstruction of the maxillary defect with discontinuity after partial maxillectomy is extremely challenging due to extensive, severe adhesions between the maxillary sinus membrane and oral mucosa, resulting in no space for the grafted bone and a lack of soft tissue to cover the graft. This case reports a 23-year-old female patient who underwent secondary reconstruction for a bone defect caused by a partial maxillectomy to remove an ameloblastoma that had invaded the maxillary sinus. We incised the existing soft tissue ridge at the bone defect and extensive adhesions below the maxillary sinus to create space for the grafted bone and to form an adequate buccal flap. To ensure the grafted bone's stability and to support the surrounding soft tissues, a cortical bone from the iliac crest was placed beneath the sinus membrane, with cancellous bone grafted underneath, and a titanium mesh was applied at the alveolar region. This approach allowed robust bone regeneration at the graft site, demonstrating dense, well-integrated new bone formation that facilitated successful implant treatment with good primary stability for 2 implants. This surgical approach, when indicated, can be less invasive than vascularized bone grafts.