Computer-assisted contouring combined with bone ostectomy for dental implant placement of craniofacial fibrous dysplasia involving the right maxilla.

Abstract

Background: Craniofacial fibrous dysplasia (CFD) affecting the jaws can result in facial asymmetry, posing a unique challenge for dental implant placement in edentulous areas. This case report introduces an innovative approach for rehabilitating the posterior maxilla affected by CFD using a computer-guided technique for maxillary recontouring and substitution bone grafting at implant sites.

Case presentation: A 58-year-old edentulous female with a craniofacial fibrous dysplasia bone lesion affecting the right maxilla was referred for correction of asymmetry and dental implant placement. A computer guide was devised for shaving and contouring the right maxilla. Following virtual maxillary reduction, a second guide was created over the osteomized 3D model to plan the location of future dental implants and guide bone ostectomies for allograft substitution. Particulate bone substitute was applied to ostectomy sites in the affected maxillary alveolar ridge. Four implants were placed successfully four months post-operation, with integration confirmed by clinical examination after one year of follow-up.

Conclusion: This treatment approach emerges as a reliable and effective modality for simultaneous dental implant rehabilitation in edentulous alveolar bone and jaw contouring in CFD cases.