Digital Technology-Enhanced Reconstruction and Rehabilitation Following Fibular Flap Grafting with implants: A Case Report

Shuang Li ^1,2* Jian Liu ^3* Jian Li ⁴ Baoheng Yin ^2,5* Yuanyong Feng ⁶ Yanshan Liu ^6* Na Bai ^2,5*

• ¹ The Affiliated Hospital of Qingdao University, Qingdao, China
• ² Department of Prosthodontics, The Affiliated Hospital of Qingdao University,, Qingdao, Shandong Province, China
• ³ Suqian Stomatological Hospital, Suqian, China
• ⁴ Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
• ⁵ School of Stomatology, Qingdao University, Qingdao, Shandong Province, China
• ⁶ Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China

Objective: The presence of benign and malignant tumors in the oral cavity frequently necessitates the partial or complete resection of the jawbone, making the restoration of dental arch morphology and masticatory function a critical objective in oral rehabilitation. Recent advancements in digital technology have significantly facilitated postoperative implant fixation following fibular flap grafting. In this paper, we report a case of posterior tooth loss after restoration of non-digital bone grafts and implants through a digital restorative process in the hope of providing a viable clinical option.Clinical considerations: A male patient was referred to our department for post-fixation restorative treatment with oral implants after completing peroneal muscle flap transfer repair for bone reconstruction and implantation due to an enamel cell tumor of the left mandible.The restorative process incorporated various digital technologies including a digital facebow, intraoral scanner, extraoral scanner, facial scanner, and CAD/CAM systems. Following one year postimplantation, the patient received second-stage implantation alongside autologous dermal allograft (ADM) transplantation; subsequently, a temporary prosthesis was fabricated while employing an electronic articulator to accurately transfer occlusal relationships before finalizing with permanent restorations. The integration of digital technology throughout this restorative process enhanced both precision and comfort.Conclusions: This case study offers an innovative and efficient clinical approach for addressing dentition defect following mandibular reconstruction via advanced digital methodologies.Digital technologies enable precise documentation tailored to unique oral environments while facilitating accurate transmission of positional relationships between maxilla and mandible. Such applications promote stable occlusal movements, minimize chairside operational time, and establish appropriate occlusal relations reflective of current jawbone conditions as well as musculoskeletal joints-ultimately improving patient comfort.