Work

Primary reconstruction of total maxillectomy defect with additively manufactured subperiosteal implant and fibula free flap: a case report

Year: 2025

Type: article

Abstract: BACKGROUND: Total maxillectomy for malignant tumors presents significant challenges for functional and aesthetic rehabilitation. Advances in digital planning and additive manufacturing have reintroduced subperiosteal implants as a promising solution for primary reconstructions. CASE REPORT: This report details the case of a 59-year-old male with squamous cell carcinoma of the hard palate extending contralaterally, treated with a total maxillectomy and primary reconstruction using an osteomyocutaneous fibula free flap combined with a custom-made, additively manufactured subperiosteal implant. Preoperative planning integrated craniofacial CT scans, dental impressions, and lower limb angiography to design both the implant and fibula cutting guides. The implant, fabricated via direct metal laser sintering, provided a stable framework for fibular segments and future prosthetic rehabilitation. At two years post-surgery, the patient remains disease-free, with no complications and fully functional prosthetic integration. CONCLUSIONS: This case highlights the feasibility, adaptability, and potential benefits of additively manufactured implants in reconstructing total maxillectomy defects. CLINICAL TRIAL NUMBER: N/A.

Source: Oral and Maxillofacial Surgery

DOI: 10.1007/s10006-025-01379-7

Authors: Giacomo De Riu, Andrea Biglio, Alessandro Baj, Antonino Maniaci, Jerome R. Lechien, Luigi Angelo Vaira

Institutions: University of Sassari, University of Milan, Università degli Studi di Enna Kore, University of Mons

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,890