Complex Maxillofacial Reconstruction – Evolution, Efficiency & Optimized Esthetics Through Digital Technology

Explore the evolution of complex maxillofacial reconstruction with Dr. Brecht. Learn how digital planning, surgical guides, and a multidisciplinary approach deliver efficient, esthetic, and functional outcomes, including immediate implant-supported rehabilitation.

Esthetic reconstruction of patients with cancer or a destructive maxillofacial lesion are perhaps the most challenging of procedures. From WWI until 1975, there were few options available to make these patients whole again in an esthetic as well as functional manner. 2024 marked the 50^th anniversary of the first fibula free flap microvascular tissue (MVFF) transfer. This procedure revolutionized the reconstruction of the patient with a defect or deformity of the maxillofacial region. The art and science of reconstruction of the mandible and maxilla subsequently progressed rapidly after developments in computational sciences and eventually virtual surgical planning. The development of computer-aided, three-dimensional planning along with computer-fabricated surgical splints and cutting guides now allow for a prosthetically-driven, occlusally-based rehabilitation in combination with unprecedented precision in surgical reconstruction of form and function. The culmination of technology employed in an active multidisciplinary team setting has resulted in the ability to deliver an implant-supported prosthetic rehabilitation for the mandibular or maxillary resection patient during a single reconstructive surgical episode. This presentation reviews the evolution of the collaborative effort of our team of a maxillofacial surgeon, microvascular head and neck surgeon and maxillofacial prosthodontist in optimizing the outcomes in our reconstruction patients.

Learning Objectives:

At the conclusion of this presentation participants will be able to or will have gained an understanding of:

1. The history of reconstructive efforts for the patient with a maxillofacial defect.
2. The benefits of an integrated team approach for addressing complex maxillofacial reconstruction.
3. The important role of digital technology in planning and executing complex maxillofacial reconstructions.
4. The value of immediate implant reconstruction of the maxilla and mandible for rehabilitation of dental function.