Fibula transplant caudal vertical distraction for reconstruction of lower jaw defect caused by firearm projectile and rehabilitated with bone-integrated implants

Resumen

The present study presents  satisfactory aesthetic and functional results achieved after correction of facial asymmetry in a patient subject to reconstruction  with fibula graft of a wound caused by firearm projectile. Equally  presented in this study is  the rehabilitation of the stomatognathic complex  through placement of bone-integrated implants. Procedure was accomplished in four surgical phases. Previous clinical and imaging evaluation was performed with support of stereolithographic studies. The first phase encompasses osteogenic distraction in caudal direction in the chin region. In the second phase, osteogenic distraction is performed  bilaterally in caudal direction in the body of the lower jaw. The third surgical phase encompasses reconstruction of the lower lip. The fourth and final surgical phase  comprehends the placement of bone-integrated implants. Through careful case analysis and available diagnostics tools surgical treatment sequence could be planned. Shape and anatomical dimension of lower jaw region could be attained. Another achievement was  correction of soft tissue scars  caused by  lower jaw reconstruction sequels. Treatment was completed  with masticatory function rehabilitation with the help of an implant-supported prosthesis.