Aesthetic rehabilitation of combined le-fort and dentoalveolar fracture: A case report with 3 years follow

Maxillofacial trauma involving one or both dental arches is often seen in automobile crashes and requires a comprehensive surgical approach, involving hemodynamic assessment, wound evaluation, foreign body inspection, and nerve, vessel, or glandular duct involvement checks. Treatment may be staged depending on the injury type and patient’s age. Le Fort I fractures, a type of transverse fracture, affect the maxilla, palate, and pterygoid processes. Le Fort fractures, when coupled with dental trauma, present challenges for restoring function and aesthetics, especially for young patients. Upper central incisors are commonly impacted due to their position and lack of lip support. Implant-supported bridges and crowns are preferred for restoring missing teeth, offering durable biological and mechanical benefits. Ideal implant placement is essential to ensure proper alignment and aesthetics, particularly in cases where bone structure is insufficient for straightforward positioning. For non-axial placements, angle-corrected abutments can mitigate the resulting biomechanical stresses, while implant-protected occlusion aids in long-term success. This case report details the management of combined Le Fort and dentoalveolar fractures using a multidisciplinary approach. After fracture fixation, implants were non-axially positioned in the anterior maxilla and successfully loaded with angulated abutments, addressing both functional and aesthetic needs. Following three years of follow-up, the results showed no complications, with off-axis implants restored using angulated abutments fulfilling biomechanical and aesthetic requirements. Implants placed at varied angles were successfully integrated, aligning with the patient’s treatment preferences and available bone structure, thus minimizing the need for additional procedures like bone grafting and sinus lifts.