Functional Reconstruction in Mandibular Avulsion Injuries.

The present report describes the planning and surgery as well as pitfalls and management of a patient with a near total mandibular avulsion injury that was rehabilitated using three-dimensional (3D) laser printing of a titanium lower jaw. Laser-sintering involves zapping layers of powdered metal to recreate a 3D implantable skeletal defect. The process involves using either mirror imaging of the unaffected side or using archival image database of healthy individuals. A 25-year-old man presented with a gunshot injury that left him with a near total avulsed mandible. The patient received state-of-the-art treatment using a laser 3D printed mandible which was connected to the muscles of mastication for functionality. The inner side of the titanium jaw was filled with the patient's comminuted fractured bones in addition to harvested iliac crest bone graft that was covered with the patient's remaining periosteal tissue. The implantation of a near total mandible using 3D laser printing is a fast and predictable process that in selected patients can result in aesthetically as well as functionally excellent results. The authors believe that the future of craniofacial reconstruction will employ these methods for facial bony reconstruction.