Hybrid mandibular reconstruction and dental implants in ameloblastoma: a case report

Abstract

Ameloblastoma is a benign odontogenic tumor with locally invasive behavior and high recurrence rates. Surgical management through segmental resection often results in extensive mandibular defects with significant functional and aesthetic sequelae. Autologous vascularized bone grafts remain the gold standard for mandibular reconstruction; however, several studies have demonstrated the feasibility of non vascularized grafts in large defects when combined with hybrid fixation techniques and implant-supported rehabilitation. We report the case of an 18-year-old male with multicystic ameloblastoma of the left mandibular body and ramus, treated with hemimandibulectomy, hybrid reconstruction using Pogrel’s technique with titanium reconstruction plate and staged autologous rib and iliac crest grafts, followed by placement of dental implants as the initial phase of definitive rehabilitation. At two year follow-up, outcomes demonstrated bone stability, absence of infectious complications, and successful osseointegration of implants. This case supports growing evidence that non-vascularized autogenous bone grafts, applied within hybrid protocols and combined with implant-supported rehabilitation, represent an effective, predictable, and cost-efficient alternative for the reconstruction of extensive mandibular defects due to ameloblastoma