A New Approach to Im plant-Based Midface Reconstruction Following Subtotal Maxillectomy

This case presentation describes the reconstruction of an extensive maxillary-orbital defect following subtotal resection of the maxilla en bloc with orbital exenteration in a young adult following the diagnosis of chondrosarcoma. A new approach to composite midface reconstruction with dental implants is described, in which computer-guided surgery (CGS) was used to obliquely position dental implants interradicularly in the residual maxilla, such that the implant tips lie in close proximity to the root apices of the remaining teeth. The implants were then used to fixate a milled-titanium bar, fabricated using computer-aided design and manufacture (CAD/CAM), and provided with attachments for the stabilization and retention of a maxillary obturator. Keywords: computer-guided surgery, hemimaxillectomy, overdenture, zygomatic implants, 3D printing