Replacement of fractured reconstruction plate with customised mandible implant: A novel technique

In the case presented the authors faced up to the urgent necessity of lateral mandibular reconstruction in a patient affected by multiple myeloma who had already experienced two consecutives ruptures of conventional load-bearing plate. Given the insufficient remaining bone surface for stable plate fixation, especially at the proximal condylar segment, further plate substitution with standard method was not practicable. Moreover, patient’s progressive declining in health, highly contraindicated mandibular reconstruction with vascularized bone graft. Therefore, it was decided to virtually plan and fabricate a customized mandible-like titanium prototyped plate, which was pre-shaped according to the individual anatomical bone conditions. The solution proposed may represent a valid option for the substitution of fractured/displaced mandibular reconstruction plates under complex anatomical conditions.