Distraction Osteogenesis and Customized Temporomandibular Joint Prosthesis in the Reconstruction of a Large Mandibular Defect - A Case Report

THE RATIONALE: Mandibular resections involve esthetic and functional impairment and impose a challenge during the reconstruction. This case report is a successful reconstruction with distraction osteogenesis (DO) and customized temporomandibular joint (TMJ) prosthesis. PATIENT CONCERNS: A 51-year-old male patient presented with a complaint of facial asymmetry, mastication, and speech difficulties. DIAGNOSIS: As the patient had undergone a hemimandibulectomy procedure 20 years ago, clinical examination showed facial asymmetry. Radiographic examination exhibited the defect and a radiopaque image representing Kirschner's wire. TREATMENT: DO by bone transport was performed, followed by dental implant and TMJ prosthesis placement. OUTCOMES: DO is a viable treatment option in resections, even when the defect was generated by an ancient injury. The follow-up is around 7 years after the osteogenic distraction, with no complaints and functional capacity. TAKE-AWAY LESSONS: The major challenge in mandibular reconstructions through DO is to reproduce the curve of the arch.