Mandibular reconstruction with a custom-made CAD/CAM porous titanium prosthesis in a 10-year-old patient and the long-term prognosis.

Abstract

Reconstruction of the mandible in growing patients following mandibulectomy is crucial for minimizing deformities and disabilities. Surgeons have been exploring various methods for mandibular reconstruction in growing patients. This case report describes the use of a custom-made CAD/CAM porous titanium prosthesis for mandibular reconstruction after the resection of ameloblastoma in a growing child, where the condylar process on the affected side was preserved. This approach avoided harvesting from a secondary donor site, such as the fibula or iliac crest. Preoperative virtual surgical planning was utilized to design the mandibular osteotomy and titanium prosthesis placement. The prosthesis featured a lightweight design with cellular lattice structures and was fabricated using 3D printing. The lesion was excised through a segmental mandibulectomy, preserving the neck and head of the condyle. Simultaneous reconstruction with the titanium prosthesis was performed. Postoperative follow-up for 45 months revealed no titanium prosthesis-related complications. The growth of the condyle on the affected side was significant, and the bilateral mandibular rami were nearly symmetrical. The patient's facial appearance was satisfactory. Oral functions, including speech and mastication, were satisfactory, and the occlusion was maintained without interference.