Prosthetic rehabilitation of maxillary and mandibular gunshot defects with fixed basal implant-supported prostheses: A 5-year follow-up case report

• Published in: International journal of surgery case reports Vol. 68; pp. 27 - 31
• Main Authors: Awadalkreem, Fadia, Khalifa, Nadia, Ahmad, Abdelnasir G., Suliman, Ahmed Mohamed, Osman, Motaz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2020; Elsevier
• Subjects: Aesthetic results; Basal implant-supported prosthesis; Defect resection; Functional outcomes; Gunshot injury; Mandibular defect; Mandibular defect; Defect resection; BCS; Aesthetic results; Functional outcomes; Gunshot injury; FPD; Basal implant-supported prosthesis
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.02.025

•Oral maxillofacial gunshot wounds have serious aesthetic and functional consequences.•Rehabilitating mandibular gunshot defects is complicated and requires a long time.•A multispecialty team is necessary to perform challenging rehabilitation procedures.•Fixed basal implant-supported prosthesis placement does not require bone grafting.•This procedure produces excellent aesthetic/functional outcomes and implant stability. Gunshot injuries to the oral maxillofacial region have serious aesthetic and functional consequences. A 32-year-old male patient presented with a marginal mandibular resection owing to a gunshot wound. A clinical examination revealed destroyed crowns in teeth 12, 11, and 21; extraction in teeth 13, 22, 24, 31, 32-45; a fracture in tooth 38; and severe pain. Further, he had multiple submental scars and a completely obliterated sulcus. Consequently, a multidisciplinary team was formed who devised the following treatment plan: stage 1, root canal treatment for the maxillary anterior teeth, followed by crown construction and transitional mandibular removable partial denture construction, and stage 2, placement of immediately loaded basal implant definitive prostheses supported by 6 corticobasal screw implants. After 5 years of use, the patient presented with excellent peri-implant soft tissue health, prosthesis stability, and great improvements in aesthetics and function. The patient was highly satisfied with the treatment and restoration of his quality of life. Accurate treatment planning is vital for managing complicated cases, including gunshot defect cases, and should involve the selection of the most suitable reconstructive technique with lower susceptible complication rates and high success rates. The described treatment eliminates the need for bone grafting, reduces treatment duration, and involves fixed prosthesis placement. To our knowledge, this is the first report on basal implant-based full-mouth rehabilitation in a gunshot mandibular defect patient. The fixed hybrid basal implant-supported prosthesis produced highly acceptable aesthetic and phonetic results and greatly improved the patient’s life.