Distraction Osteogenesis and Customized Temporomandibular Joint Prosthesis in the Reconstruction of a Large Mandibular Defect - A Case Report.

The Rationale: Mandibular resections involve esthetic and functional impairment and impose a challenge during the reconstruction. This case report is a successful reconstruction with distraction osteogenesis (DO) and customized temporomandibular joint (TMJ) prosthesis.

Patient Concerns: A 51-year-old male patient presented with a complaint of facial asymmetry, mastication, and speech difficulties.

Diagnosis: As the patient had undergone a hemimandibulectomy procedure 20 years ago, clinical examination showed facial asymmetry. Radiographic examination exhibited the defect and a radiopaque image representing Kirschner's wire.

Treatment: DO by bone transport was performed, followed by dental implant and TMJ prosthesis placement.

Outcomes: DO is a viable treatment option in resections, even when the defect was generated by an ancient injury. The follow-up is around 7 years after the osteogenic distraction, with no complaints and functional capacity.

Take-away Lessons: The major challenge in mandibular reconstructions through DO is to reproduce the curve of the arch.