Treatment of Mandibular Ameloblastoma Involving the Mandibular Condyle: Resection and Concomitant Reconstruction With a Custom Hybrid Total Joint Prosthesis and Iliac Bone Graft

Aim: To describe the treatment of ameloblastoma involving the mandibular body and condyle in 3 patients. Methods: This report describes 3 patients with large ameloblastomas (2 were second recurrences) treated by partial mandibular resection. Involvement of the mandibular condyle in these 3 patients made the reconstruction more challenging. Reconstruction included immediate temporomandibular joint replacement by a custom-made alloplastic total joint and mandibular body (Zimmer-Biomet, Jacksonville, FL). These devices were designed using virtual surgical planning software. The 3 patients underwent concomitant bone graft reconstruction using autogenous-free corticocancellous block bone grafts from the iliac crest. This facilitated later dental implant placement and full dental rehabilitation. Direct inferior alveolar nerve repair or nerve graft reconstruction with allograft was also carried out for all 3 patients. Maxillomandibular fixation was not used in all 3 patients. Results: All the 3 patients underwent successful surgery and recovery. Mandibular function was preserved. The concomitant bone graft allowed successful dental implant placement for subsequent planned restorative dentistry. Conclusion: Ameloblastoma involving the mandibular condyle can be successfully treated by resection and concomitant total joint replacement with an alloplastic device. This technique shows promise in that there is rapid return to excellent function thanks to rigid fixation of the construct. Mirroring software used in the prosthesis design facilitates excellent cosmetic outcomes. Address correspondence and reprint requests to Mathilde Sarlabous, DMD, FRCDC, MSc, Fountain View Oral Facial and Implant Surgery, 4288 Village Centre Court, 1st Floor, Mississauga, Ontario, Canada L4Z 1S2; E-mail: contact.sarlabous@gmail.com Received 17 June, 2017 Accepted 12 December, 2017 DJP occasionally presents continuing education seminars on behalf of Zimmer Biomet. No compensation was received for this study. The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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