ICMFS 2019

Complex Orofacial Rehabilitation Patients of Maxillary Defects after Oncological Resection: Zygomatic Implants and Patient-Specific Implants Made 3D Printed

Aleksandr Mordovskiy Andrey Polyakov Sergey Epifanov Denis Dorohin Irina Rebricova Oleg Matorin Natalia Vereshchagina
Department of Microsurgery, Moscow Research Oncological Institute Named P.A. Herzen – The Branch of State Organization «National Medical Research Center of Radiology», Ministry of Health of Russia

Objectives: to evaluate the clinical effectiveness of maxillary rehabilitation with zygomatic implant and patient-specific implants made 3D printed after tumor resection.

Methods: Clinical examples of successful treatment of 7 patients with malignant tumors midfacial. Osteogenic sarcoma G3 was diagnosed in 1 patient, 3 cases were cancer minor salivary gland of the palate and 2 cases were squamous cell carcinoma mucosa maxillary sinus. After tumor resection there were big maxilla defects. According to classification by J. S. Brown and R. J. Shaw maxilla defects were fited III d class for 3 patients, and III d/c class for 4 patients.In 6 patients were performed simultaneous operation removal of malignant neoplasm and reconstruction maxilla defects, 1 patent had a delayed surgical treatment. In 5 cases were performed reconstruction postresection defects upper jaw using intraosseous screw zygomatic implants and 2 cases using individual titanium endoprosthesis periosteal type.

Results: All implants were osseointegrated. All patients restored aesthetic parameters: midface was saved, scar tissue retraction and recessing of the upper lip and nose were prevented. Cases with using patient specific implants (made 3d printed) permanent prosthesis was fixing at five days postoperation. By the end of the week at them were restored completely swallowing, masticate and speak. In 5 patients with implants «Zygoma» type fixing permanent prosthesis was installed for 20 days, after making beam construction. At them full rehabilitation was attained in the middle after 24 days post OP.

Conclusion: The results show that zygoma implants could represent a viable surgical option to obtain a satisfactory oral function rehabilitation even in case of extensive maxillary defect. Using individual implants periosteal type 3D – printing method we rehabilitated patients in early terms (7 days).

Aleksandr Mordovskiy
Aleksandr Mordovskiy








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