The technique to resect a maxilla and/or mandible for tumor removal, reconstruct the surgical defect with a microvascular free flap tissue transfer, place endossesous dental implants and deliver an immediate prosthetic rehabilitation all in one surgical procedure has been in use now for more than 10 years. Much has been learned by the several teams that almost simultaneously reported their experiences in the evolution to developing the technique. Over this period, the procedure has been modified and refined and the scope of its application has been expanded. This presentation describes the evolution of the technique pioneered by one surgical-prosthetic team. The advantages and disadvantages of the various modifications of the technique developed over the years will be reviewed. In addition, the importance of cutting guide design, reconstruction plate design and implant design will be discussed. Complications as well as surgical and prosthetic challenges that have been encountered will also be reviewed.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Understand the rationale for continued cutting guide evolution.
Understand the rationale for implant design modifications.
Understand the management protocols for complications.