Virtual planning, guided surgery, and digital prosthodontics in the treatment of extended mandible chondrosarcoma

J Prosthodont. 2023 Dec 19. doi: 10.1111/jopr.13819. Online ahead of print.

Abstract

Chondrosarcoma is among the most common primary bone tumors in adults. In the mandible, chondrosarcoma is a very uncommon malignant cartilage-producing tumor. This case report shows how virtual planning combined with other digital technologies may improve masticatory function rehabilitation in patients with enlarged mandibular chondrosarcoma. The present study reports a case of a 52-year-old male patient who was initially diagnosed with a mandible chondroma, which was successfully excised with no evidence of malignant transformation. Nevertheless, the patient's symptoms recurred after 10 years, and a subsequent diagnosis of mandible chondrosarcoma was established, prompting the need for subtotal mandible resection and reconstruction with a fibula-free flap. Following a healing period, the patient underwent dental implant surgery to restore the mandibular dental arch, which was performed utilizing computer-aided design and computer-aided manufacturing technology, with fully guided implant placement facilitated by virtual planning. In this case report, the implant position data merging process is described from the digital impression and control model to ensure optimal passive fit of the full-arch zirconia prosthesis and discuss the importance of occlusal adjustments to avoid technical and biological complications. Virtual planning and digital technologies are crucial for the effective management of mandibular defects, allowing for accurate treatment and complete restoration of mandibular function. Their use leads to improved patient outcomes and quality of life. As technology advances, their importance in treating complex medical conditions is only expected to grow.

Keywords: chondrosarcoma; digital prosthodontics; mandible resection; virtual planning.