Knöcherne Rekonstruktionen des Ober- und Unterkiefers – Grundprinzipien, virtuelle Planung und intraoperative Umsetzung

Abstract

Particularly after ablative surgery for head and neck cancer, microvascular free flaps represent the gold standard in reconstructive surgery. The increasing demand for improved postoperative quality of life requires a high standard of functional and esthetic reconstructive results. Depending on the nature of the defect, a huge variety of different free flaps are suitable for reconstruction. In oral and maxillofacial surgery, bony reconstruction is essential for restoring critical functions including speech, mastication, and swallowing. Here, virtual surgical planning and its translation to the operation using prefabricated surgical resection or osteotomy guides in combination with patient-specific implants has contributed to a high level of accuracy, leading to more precise prediction of the reconstructive result. Usually, complete dental rehabilitation after bony reconstruction includes insertion of dental implants, a process which can often take a significant amount of time before the definitive prosthetic restoration can be attached. Hence, the jaw-in-a-day concept provides the possibility of full dental rehabilitation simultaneously with the bony reconstruction. However, this promising tool requires careful patient selection and remains to be evaluated in the long term.