2026 Volume 39 Issue 2 Pages 123-128
Prosthetic rehabilitation following extensive maxillary defects after resection of malignant tumors remains a major clinical challenge in terms of functional recovery. This report describes a case in which favorable occlusal rehabilitation was achieved using a fixed prosthesis supported by bone anchored devices for wide edentulous areas after maxillary reconstruction with a vascularized fibula free flap.
A 58-year-old man presented with discomfort and masticatory difficulty while wearing a maxillary obturator prosthesis. Because the patient desired functional recovery with a fixed prosthesis, implant therapy using bone anchored devices for wide edentulous areas was planned. These devices were placed in the reconstructed fibula bone, and flap thinning combined with vestibuloplasty was performed during second-stage surgery. A screw-retained fixed definitive prosthesis was subsequently delivered to restore occlusion.
After delivery of the definitive prosthesis, satisfactory masticatory function and oral hygiene were maintained. During more than 7 years of follow-up, no biological or technical complications were observed in the peri-device tissues or the prosthetic superstructure.
This case suggests that fixed prosthetic rehabilitation using bone anchored devices for wide edentulous areas after maxillary reconstruction with a fibula free flap can provide stable long-term functional outcomes when appropriate bone reconstruction and soft tissue management are achieved.
