Abstract
INTRODUCTION: Segmental mandibular reconstruction using free fibula flaps and implants is challenging for maxillofacial surgeons and prosthodontists. This case report describes the successful use of Corticobasal implant reconstructive prostheses after a free fibula flap with five years of follow-up. CLINICAL CASE PRESENTATION: A 24-year-old female presented to the clinic following segmental defect reconstruction using fibula reconstruction, owing to squamous cell carcinoma resection and seeking prosthetic treatment. An intraoral examination revealed a complete healing of the soft tissue. A panoramic radiograph showed a fibula bone graft rehabilitating the left side of the mandible supporting with a reconstructive plate. A multidisciplinary team was formed. A treatment plan included a mandibular reconstructive fixed Corticobasal implant prosthesis supported by eight basal cortical screw implants (BCS®, Dr. Ihde Dental AG, Switzerland) and a follow-up schedule was formulated. After 5-years of function, the implant demonstrated a 100 % survival rate, with no implant loss or fracture, excellent peri-implant soft tissue health, complete union of the bone graft, and a very stable prosthesis. The patient reported significant improvements in aesthetics, mastication, phonation, and self-satisfaction. DISCUSSION: The multidisciplinary team has significantly improved the treatment outcomes. The prescribed treatment modality provides the patient with a fixed treatment modality, immediate loading, reduces the risk of biological and biomechanical complications, and hence improves the patient's functions and satisfaction. CONCLUSION: A Corticobasal implant-supported prosthesis can be used in combination with a free fibula flap to reconstruct segmental mandibulectomy patients with a high survival rate and satisfactory aesthetic and functional outcomes.