Journal of Prosthodontics News
Dental Prosthesis Extraoral Indexing and Pick-Up Technique for Full-Arch Rehabilitation
Now online in the Journal of Prosthodontics, a report of a technique for mandibular full-arch immediate rehabilitation in fibula free flap reconstruction co-authored by ACP Fellow, Michael R. Andersen, DDS, MS, FACP.
Dental implants placed into the fibula free flap allow for dental reconstruction of patients with mandibular trauma or pathology. In 2013, head and neck reconstructive surgery was revolutionized with the first description of a same-day virtual guided resection, fibula reconstruction, and fibula-borne implant-retained dental prosthesis delivery (“Jaw in a Day” (JIAD) surgery).
Critical to the success of same-day dental rehabilitation is an accurate and reproducible pick up technique. The goals of a successful technique include the establishment of satisfactory occlusion of the immediate prosthesis and minimal intraoperative adjustments.
This report describes a novel extraoral dental prosthesis indexing and pick-up technique for mandibular fibula free flap full-arch reconstruction using a fully digital workflow and a lightweight, hinged articulator. The upper member is designed with a positioning index and vertical stops, and the lower member has predictive screw holes for positioning the fibula free flap. By leveraging a streamlined digital workflow and this novel extraoral dental prosthesis indexing and positioning articulator, a dental prosthesis is predictably indexed to the neomandible to maintain the predesigned occlusion and vertical dimension of occlusion.
This method minimizes intraoperative adjustments to reduce operating room time compared to traditional intraoral indexing techniques for full-arch immediate dental prostheses. Furthermore, the dental prosthesis on the neomandible acts as an external fixation device to help prevent unwanted “rolling” of a fibula segment during fixation of the reconstruction plate and immediately rehabilitates patients with dental prosthetics.
Betz, SJ, Hammer, DA, Andersen, MR. Dental prosthesis extraoral indexing and pick-up technique for mandibular full-arch immediate rehabilitation in fibula free flap reconstruction. J Prosthodont. 2023; 1–6. https://doi.org/10.1111/jopr.13800
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