Implant Reconstruction of a Large Mandibular Defect Following Removal of a Nonossifying Fibroma

The fixed implant-supported restoration of this mandibular surgical defect deliberately violated the principles of mandibular flexure, crown-to-implant ratio, and off-axis loading. A custom-made implant-mounted jig revealed no mandibular flexure in this patient, but crown-to-root ratios of up to 39:12 were unavoidable. The restoration has needed no maintenance for 14 years. This apparent success calls into question the blind application of prevailing clinical principles.