Use of cad/cam technology in the treatment of ameloblastoma: a case report

Willian Gabriell de Matos Araújo Moraes; Arianne Kimberly Barbosa da Matta; Marco Túllio Becheleni Ávila Guimarães; Wagner Henriques de Castro

doi:10.5327/2525-5711.432

Authors

Willian Gabriell de Matos Araújo Moraes Universidade Federal de Minas Gerais, Hospital das Clínicas – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0002-5545-1795
Arianne Kimberly Barbosa da Matta Universidade de São Paulo, Faculdade de Odontologia – Ribeirão Preto (SP), Brazil. https://orcid.org/0000-0003-0039-9560
Marco Túllio Becheleni Ávila Guimarães Universidade Federal de Minas Gerais, Hospital das Clínicas – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0003-2576-3680
Wagner Henriques de Castro Universidade Federal de Minas Gerais, Hospital das Clínicas – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0003-2745-2878

DOI:

https://doi.org/10.5327/2525-5711.432

Keywords:

Ameloblastoma, CAD-CAM, Mandibular Reconstruction

Abstract

Ameloblastoma is the most common benign epithelial odontogenic tumor, although it is aggressive and locally invasive, and its treatment frequently results in mandibular defects requiring complex reconstruction. This case report describes a secondary mandibular reconstruction using an iliac crest graft (ICG) assisted by Computed-Aided Design and Computed-Aided Manufacturing (CAD–CAM) technology. A 28-year-old female who was diagnosed with Ameloblastoma in the mandibular region underwent segmental mandibular resection followed by delayed reconstruction planned through virtual surgical planning, mandibular mirroring, and fabrication of patient-specific cutting guides and stereolithographic models. The CAD–CAM workflow enabled accurate graft harvesting and adaptation, and reduced operative time, enhancing surgical predictability and minimizing morbidity. The patient subsequently achieved satisfactory functional and aesthetic rehabilitation and remains under long-term follow-up without recurrence. This report highlights the applicability of CAD–CAM as a reliable and precise strategy for mandibular reconstruction after tumor resection.

References

1. Saghravanian N, Salehinejad J, Ghazi N, Shirdel M, Razi M. A 40-year retrospective clinicopathological study of ameloblastoma in Iran. Asian Pac J Cancer Prev. 2016;17(2):619-23. https://doi.org/10.7314/apjcp.2016.17.2.619

2. Abbate V, Togo G, Committeri U, Zarone F, Sammartino G, Valletta A, et al. Full digital workflow for Mandibular Ameloblastoma management: showcase for technical description. J Clin Med. 2023;12(17):5526. https://doi.org/10.3390/jcm12175526

3. Silva CCG, Perrelli MCG, Silva MEDA, Gonçalves KKN, Diniz DA, Carneiro SC. Reconstrução mandibular com enxerto livre de crista ilíaca: relato de caso. Odontol Clín Cient. 2021;20(3):88-92.

4. Barros MAN, Teslenco VB, Reis GN, Pancini EF, Cavalcanti HA. Enxerto ósseo autógeno de crista ilíaca para tratamento de defeito mandibular. Arch Health Invest. 2021;10(4):615-8. https://doi.org/10.21270/archi.v10i4.4916

5. Srivastava G, Padhiary SK, Nayak TK, Mishra N. Rehabilitation using implants in free fibula flap of a patient with ameloblastoma: case report with 4-year follow-up. Natl J Maxillofac Surg. 2022;13(Suppl 1):S194-8. https://doi.org/10.4103/njms.NJMS_239_20

6. Ghai S. Ameloblastoma: an updated narrative review of an enigmatic tumor. Cureus. 2022;14(8):e27734. https://doi.org/10.7759/cureus.27734

7. Tarsitano A, Mazzoni S, Cipriani R, Scotti R, Marchetti C, Ciocca L. The CAD-CAM technique for mandibular reconstruction: an 18 patients oncological case-series. J Craniomaxillofac Surg. 2014;42(7):1460-4. https://doi.org/10.1016/j.jcms.2014.04.011

8. Alarcón‑Sánchez MA, Becerra‑Ruíz JS, Yessayan L, Ali Mosaddad S, Heboyan A. Implant‑supported prosthetic rehabilitation after Ameloblastomas treatment: a systematic. 2023;23(1):1013. https://doi.org/10.1186/s12903-023-03765-7

9. Moura LB, Carvalho PHA, Xavier CB, Post LK, Torriani MA, Santagata M, et al. Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review. Int J Oral Maxillofac Surg. 2016;45(11):1388-94. https://doi.org/10.1016/j.ijom.2016.05.004

10. Probst FA, Liokatis P, Mast G, Ehrenfeld M. Virtual planning for mandible resection and reconstruction. Innov Surg Sci. 2023;8(3):137-48. https://doi.org/10.1515/iss-2021-0045

11. Kang YF, Ge YJ, Lv XM, Ding MK, Shan XF, Cai ZG. One-stage jaw reconstruction and prosthetic rehabilitation with an iliac flap: a case report and literature review. Maxillofac Plast Reconstr Surg. 2024;46(1):3. https://doi.org/10.1186/s40902-024-00413-0