Individualized Reconstruction Of Infective Segmental Mandibular Defects Via IMT

By using CAD/CAM-assisted induced membrane technology (IMT), personalized restoration was achieved in this case with a segmental mandibular defect caused by mandibular osteomyelitis and pathological fracture. It is expected to provide new methods for the reconstruction of segmental mandibular defects. A 48-year-old man who underwent resection of a left parotid myoepithelioma via split ramus osteotomy 7 months ago, was admitted due to significant swelling accompanied by two fistulas with yellowish-white pus discharge on his left face for 1 month. He had a 5-year history of diabetes with poor glucose control. CBCT showed chronic osteomyelitis with a pathological fracture in the left mandibular angle with a retained titanium plate. Based on controlling infection, surgical treatment included one-stage and two-stage surgery. One-stage surgery included resection of the infected lesion, removal of the titanium plate, and cementoplasty with a surgical guide. After six months, the bone cement was removed and autologous iliac particle grafting was performed. Postoperatively, the patient’s masticatory function returned to normal. CT showed that the grafted cancellous bone was healed, which displayed a typical sandwich structure of mandible. IMT has the characteristics of surgical ease, minimal donor-site damage, and the ability to repair irregular defects in a personalized manner, which is worthy of popularization in clinical use. IMT can achieve personalized repair of segmental mandibular defects caused by infection and trauma. It is expected to become a novel technology for treating various types of segmental mandibular defects.