Restoring Occlusion Ahead Of Relocating Dislocated Edentulous Maxilla

For dislocated edentulous maxilla, orthognathic reconstruction may not be successful due to the lack of physical support for the relocated maxilla. To solve this problem, we conceived a “start from the end” strategy with the aid of digital designing. In preparation, a relocation of the maxilla and a restoration of the occlusion with implants were digitally designed on a patient-specific virtual model. Following this design, implantation was carried out first and the occlusion restored with a temporary denture. On the next day, a Le Fort I osteotomy was carried out and the intermaxillary relationship was corrected according to the design and using the restored occlusion as the guide. Immediate loading of the restored occlusion provided a physical support for the relocated maxilla during the healing process, and strengthened the tension of the facial muscles which further contributed to stabilize the reconstructed intermaxillary relationship. In summary, the digital-design-aided one-step protocol presented in this study consisting of a occlusion restoration with implants and a subsequent relocation of the maxilla via an Le Fort I osteotomy provide an treatment option for functional and aesthetic rehabilitation of dislocated edentulous maxilla.