{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:54:51Z","timestamp":1783727691873,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,6]],"date-time":"2022-08-06T00:00:00Z","timestamp":1659744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Maxillectomies cause malocclusion, masticatory disorders, swallowing disorders and poor nasolabial projection, with consequent esthetic and functional sequelae. Reconstruction can be achieved with conventional approaches, such as closure of the maxillary defect by microvascular free flap surgery or prosthetic obturation. Four patients with segmental maxillary defects that had been reconstructed with customized subperiosteal titanium maxillary implants (CSTMI) through virtual surgical planning (VSP), STL models and CAD\/CAM titanium mesh were included. The smallest maxillary defect was 4.1 cm and the largest defect was 9.6 cm, with an average of 7.1 cm. The reconstructed maxillary vertical dimension ranged from 9.3 mm to 17.4 mm, with a mean of 13.17 mm. The transverse dimension of the maxilla at the crestal level was attempted to be reconstructed based on the pre-excision CT scan, and these measurements ranged from 6.5 mm in the premaxilla area to 14.6 mm at the posterior level. All patients were rehabilitated with a fixed prosthesis on subperiosteal implants with good esthetic and functional results. In conclusion, we believe that customized subperiosteal titanium maxillary implants (CSTMI) are a safe alternative for maxillary defects reconstruction, allowing for simultaneous dental rehabilitation while restoring midface projection. Nonetheless, prospective and randomized trials are required with long-term follow-up, to assess its long-term performance and safety.<\/jats:p>","DOI":"10.3390\/jcm11154594","type":"journal-article","created":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T22:51:46Z","timestamp":1659912706000},"page":"4594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Virtual Surgical Planning and Customized Subperiosteal Titanium Maxillary Implant (CSTMI) for Three Dimensional Reconstruction and Dental Implants of Maxillary Defects after Oncological Resection: Case Series"],"prefix":"10.3390","volume":"11","author":[{"given":"Jose Lu\u00eds","family":"Cebri\u00e1n Carretero","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Del Castillo Pardo de Vera","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8703-7134","authenticated-orcid":false,"given":"N\u00e9stor","family":"Montesdeoca Garc\u00eda","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Luz, 28003 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5066-3935","authenticated-orcid":false,"given":"Pablo","family":"Garrido Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Luz, 28003 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Mar\u00eda","family":"Pamp\u00edn Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3341-976X","authenticated-orcid":false,"given":"I\u00f1igo","family":"Arag\u00f3n Ni\u00f1o","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1890-9725","authenticated-orcid":false,"given":"Ignacio","family":"Navarro Cu\u00e9llar","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9869-9240","authenticated-orcid":false,"given":"Carlos","family":"Navarro Cu\u00e9llar","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1016\/j.bjps.2016.05.003","article-title":"A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality","volume":"69","author":"Wijbenga","year":"2016","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.bjoms.2009.12.007","article-title":"Systematic review of primary osseointegrated dental implants in head and neck oncology","volume":"49","author":"Barber","year":"2011","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.11607\/ijp.5161","article-title":"Implant utilization and time to prosthetic rehabilitation in conventional and advanced fibular free flap reconstruction of the maxilla and mandible","volume":"30","author":"Chuka","year":"2017","journal-title":"Int. J. Prosthodont."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00006534-198907000-00014","article-title":"Fibula free flap: A new method of mandible reconstruction","volume":"84","author":"Hidalgo","year":"1989","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.coms.2013.01.004","article-title":"Maxillary reconstruction","volume":"25","author":"Lenox","year":"2013","journal-title":"Oral Maxillofac. Surg. Clin. North Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.cxom.2020.05.008","article-title":"Three-Dimensional Computer-Assisted Surgical Planning and Manufacturing in Complex Maxillary Reconstruction","volume":"28","author":"Breik","year":"2020","journal-title":"Atlas Oral Maxillofac. Surg. Clin. North Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.joms.2017.11.042","article-title":"Using an In-House Approach to Computer-Assisted Design and Computer-Aided Manufacturing Reconstruction of the Maxilla","volume":"76","author":"Numajiri","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/scd.12471","article-title":"Definitive maxillary obturator prosthesis: Timelines for fabrication and follow-up","volume":"40","author":"Ahmed","year":"2020","journal-title":"Spec. Care Dent."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chou, P.Y., Denadai, R., Hallac, R.R., Dumrongwongsiri, S., Hsieh, W.C., Pai, B.C., and Lo, L.J. (2019). Comparative Volume Analysis of Alveolar Defects by 3D Simulation. J. Clin. Med., 8.","DOI":"10.3390\/jcm8091401"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1055\/s-0028-1098966","article-title":"Application of skeletal buttress analogy in composite facial reconstruction","volume":"2","author":"Rodriguez","year":"2009","journal-title":"Craniomaxillofac. Trauma Reconstr."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Navarro Cu\u00e9llar, C., Tousidonis Rial, M., Ant\u00fanez-Conde, R., Ochandiano Caicoya, S., Navarro Cu\u00e9llar, I., Arenas de Frutos, G., Sada Urmeneta, \u00c1., Garc\u00eda-Hidalgo Alonso, M.I., Navarro Vila, C., and Salmer\u00f3n Escobar, J.I. (2021). Virtual Surgical Planning, Stereolitographic Models and CAD\/CAM Titanium Mesh for Three-Dimensional Reconstruction of Fibula Flap with Iliac Crest Graft and Dental Implants. J. Clin. Med., 10.","DOI":"10.3390\/jcm10091922"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/MOO.0000000000000618","article-title":"The use of 3D virtual surgical planning and computer aided design in reconstruction of maxillary surgical defects","volume":"28","author":"Glas","year":"2020","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ijom.2018.06.010","article-title":"Patient-specific sub-periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection","volume":"48","author":"Vosselman","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.coms.2018.12.005","article-title":"Maxillofacial Reconstruction Using Vascularized Fibula Free Flaps and Endosseous Implants","volume":"31","author":"Patel","year":"2019","journal-title":"Oral Maxillofac. Surg. Clin. North Am."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.ijom.2021.05.011","article-title":"Mechanical evaluation of a patient-specific additively manufactured subperiosteal jaw implant (AMSJI) using finite-element analysis","volume":"51","author":"Huys","year":"2022","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.jcms.2016.04.013","article-title":"Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial","volume":"44","author":"Kumar","year":"2016","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Van den Borre, C., Rinaldi, M., De Neef, B., Loomans, N.A., Nout, E., Van Doorne, L., Naert, I., Politis, C., Schouten, H., and Klomp, G. (2021). Radiographic evaluation of bone remodeling after additively manufactured subperiosteal jaw implantation (Amsji) in the maxilla: A one-year follow-up study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10163542"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ijom.2018.08.001","article-title":"Evolutionary steps in the design and biofunctionalization of the additively manufactured sub-periosteal jaw implant \u2018AMSJI\u2019 for the maxilla","volume":"48","author":"Mommaerts","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/j.ijom.2017.02.002","article-title":"Additively manufactured sub-periosteal jaw implants","volume":"46","author":"Mommaerts","year":"2017","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5420391","DOI":"10.1155\/2018\/5420391","article-title":"Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants: A Retrospective Clinical Study on 70 Patients","volume":"2018","author":"Cerea","year":"2018","journal-title":"BioMed Res. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"507","DOI":"10.4103\/ams.ams_263_20","article-title":"The role of custom-made subperiosteal implants for rehabilitation of atrophic jaws\u2014A case report","volume":"10","year":"2020","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jormas.2018.06.007","article-title":"A subperiosteal maxillary implant causing severe osteolysis","volume":"119","author":"Nguyen","year":"2018","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ijsu.2020.11.005","article-title":"The PROCESS 2020 Guideline: Updating Consensus Preferred Reporting Of CasESeries in Surgery (PROCESS) Guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. 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