Mandibular angle augmentation using customized PEEK implants and guides generated with 3D Planning and Printing: case estudies

Abstract

Mandibular angle augmentation is a procedure that, despite its obvious aesthetic and reconstructive indications, is not routinely performed, even by experienced surgeons. We present a case series of 10 patients treated with custom-made mandibular or inferior border prostheses for aesthetic concerns and sequelae following trauma or orthognathic surgery. Customized implants were designed with CAD/CAM technology, milled from Polyetheretherketone (PEEK) and 3D-printed implant placement guides were used. Ten patients (6 men and 4 women) were included; median age was 36.5 years (28-45 years). Indications for surgery were aesthetics (5 cases) and postoperative sequelae (4 orthognathic surgery and 1 mentoplasty). No significant early complications occurred, except edema and small bruises. Three patients developed wound dehiscence and prosthesis exposure, which closed spontaneously after 2-3 weeks, except one case that required a slight reduction of the upper edge of the prosthesis. No prostheses required removal. After the initial healing period there were no exposures or any late-onset infections or prosthesis intolerance. The use of customized PEEK prostheses together with tooth-supported guides provides treatment that is safe, easier surgically and more reliable. More experience is needed to define bone beauty standards to achieve the desired aesthetic results