Implant-Supported Hybrid Prosthesis for Severe Mandibular Defects: A Sequence of Treatments From Alveolar Distraction Osteogenesis to Implant Restoration.

ABSTRACT

PURPOSE: Although a variety of treatment methodologies for the physiological reconstruction of mandibular defects exist, the use of these methods has often been fragmented and has focused on partial effects of therapy. This article describes a sequence of treatments for a severe mandibular defect. PATIENTS AND METHODS: Two patients with severe hard and soft tissue defects had physiological function restored in 4 steps, including alveolar distraction osteogenesis, implant insertion based on a prosthesis, application of dermal matrix membrane in reconstruction of attachment gingiva, and the use of a hybrid prosthesis designed via computer-aided design and computer-aided manufacturing, to produce an adequate bone tissue volume, an adequate amount of attached gingiva, and a reliable prosthesis. RESULTS: The sequence of treatments successfully achieved physiological reconstruction. Biological complications around the implants and mechanical complications in the implants or prostheses did not occur within a 4-year follow-up period. CONCLUSIONS: On the basis of the current 4-year follow-up, this study shows that a treatment sequence can be predictable and effective for severe mandibular defects, which suggests that it could be considered a potential protocol for patients with severe mandibular defects.