Rehabilitation with implants after maxillectomy: Clinical case
In 2015, this 57-year-old female patient came to an orofacial rehabilitation consultation, dissatisfied with the aesthetics and functionality of her current prosthesis.
After a clinical examination, it was gathered that she had been diagnosed with a squamous cell carcinoma in the palate, in the second quadrant, and had undergone a surgical excision and subsequent radiotherapy in 2008.
The treatment plan for this patient was outlined with the goal of performing a rehabilitation using implants.
To do so, it was necessary to perform a microsurgical flap from the iliac crest to close the previous surgical site with bone and soft tissues, thus enabling the placement of implants.
Three implants were planned, RN Straumann®, two free gingival grafts for the reconstruction of the missing vestibule, and, finally, a overdenture to rehabilitate the edentulous space.
At an initial stage, we opted for a removable prosthetic rehabilitation over implants, allowing us to observe the behavior of the peri-implant tissues and facilitate hygiene for the patient.
Later, if there are no complications with the tissues mentioned above, we could move forward with a fixed ceramic prosthesis over implants, which should have an excellent design allowing for proper hygiene.
Conclusion
Post-oncological maxillary reconstruction is still a recent technique, but it allows for rehabilitation with implants.
This process is the culmination of the entire reconstructive phase, providing patients with access to comfortable, aesthetically favorable prostheses capable of restoring phonetics and swallowing lost during the intervention, ultimately improving the quality of life for these already fragile patients.
