Single-Stage Mandibular Reconstruction with Pre-mounted Dental Implants in a Patient-Specific Titanium Framework Following Odontogenic Keratocyst Resection: A Digital Innovation

Mandibular reconstruction following Odontogenic Keratocyst (OKC) resection poses significant challenges in restoring both structural integrity and functional dentition. Traditional approaches require multiple surgeries and extended rehabilitation periods. This case report presents a 70-year-old male requiring anterior mandibular reconstruction following OKC resection from teeth #31 to 46. Using an innovative fully digital workflow, a patient-specific titanium implant (PSI) with pre-integrated dental implants via Direct Metal Laser Sintering (DMLS) was designed and fabricated. The PSI featured a gradient mesh architecture optimized through finite element analysis, with dental implants precisely positioned and laser-welded during fabrication. Single-stage surgical placement was followed by prosthetic rehabilitation at 3 months using a digitally designed DMLS-fabricated acrylic-metal hybrid prosthesis. At 18-month follow-up, the patient demonstrated complete functional restoration with optimal mastication, speech articulation, and facial symmetry. Radiographic evaluation confirmed excellent osseointegration without complications. The integrated digital workflow reduced treatment time by 40% compared to conventional protocols. This case represents the first reported use of pre-mounted dental implants within a PSI for mandibular reconstruction, demonstrating how advanced digital technologies can streamline complex rehabilitative procedures while achieving superior functional outcomes.