Mandibular Reconstruction Using Autologous Iliac Bone and Titanium Mesh Reinforced by Laser Welding for Implant Placement

Segmental mandibulectomy is a treatment option for benign and malignant neoplasms of the mandible. Although reconstructing the mandible of a patient with a missing segment is difficult, it is essential to improve the postoperative course of the patient. Mandibular reconstruction using titanium mesh is a useful technique for dental implant placement because the morphology of the mandible can be easily reproduced. However, fitting titanium mesh to the remaining mandible is not an easy task during surgery. The present report introduces a method in which a 3-dimensional skull model fabricated by means of stereolithography is prepared, based on computerized tomography (CT) scans, to construct a titanium mesh cage matching the shape of the mandible, preoperatively. Furthermore, the load-bearing area of the titanium mesh cage is reinforced by laser welding another layer of titanium mesh to reduce the incidence of metal fatigue during jaw movement. Keywords: dental implant, iliac bone graft, laser welding, mandibular reconstruction, titanium mesh