Mandible Reconstruction With Custom-Made Plates in Medication-Related Osteonecrosis of the Jaw—A Case Series

Abstract

Background: Restoration of the mandibular region after segmental resection surgery is crucial for masticatory function and facial aesthetics. The precision of three-dimensional printers has advanced in recent years, enabling the development of fully customized reconstruction plates. In recent years, three-dimensional printing technology has been applied in the field of dental and oral surgery. Among these, the selective laser melting method has been developed. This case report was aimed at exploring the utility in restoring mandibular morphology. Cases: Patients diagnosed with medication-related osteonecrosis of the jaw (MRONJ) in Oral and Maxillofacial Surgery at Kanazawa Medical University Hospital who underwent mandibular disarticulation and immediate completely customized reconstruction plate (COSMOFIX) were included. Case 1 involved a female in her 70s with MRONJ on the right side of the mandible. Case 2 involved a female who received bisphosphonates for extensive metastatic breast cancer, resulting in MRONJ affecting the bilateral mandible. Case 3 involved a woman who developed MRONJ on the right side of the mandible during alendronate treatment for osteoporosis. Completely customized reconstruction plates were used for reconstruction after segmental resections. Findings: The three patients adapted to the remaining bone. The reconstructed and preoperative mandibular morphologies were similar. Conclusions: In conclusion, the use of completely customized reconstruction plates obviates the need for bending and other adaptations, reduces surgical time, and improves postoperative aesthetics. Of significance, preparing completely customized reconstruction plate requires about 3 weeks; thus, careful case selection and scheduling are indispensable.