Implant-prosthetic rehabilitation of mandibular post-traumatic severe dentoalveolar loss with a reconstructive staged approach: a clinical report with 3-year follow-up

: The clinical report describes the oral rehabilitation of a 25-year-old male patient who lost lower incisors, right canine, and a significant amount of anterior mandibular bony and soft tissue following severe dentoalveolar trauma due to a car accident. The patient's young age, anterior aesthetic zone in the lower jaw, previous mandibular fracture, extended bony and soft tissue defect hindering ideal three-dimensional implant placement oriented the therapeutic plan towards a staged approach, with several reconstructive surgical procedures before implant rehabilitation. The treatment involved: the labio-buccal vestibule and lingual sulcus deepening to correct the cicatricial shrinkage due to the previous surgical fixation of the mandibular fracture, the vertical guided bony augmentation to regenerate adequate volumes of bone, free gingival graft to achieve sufficient height and thickness of peri-implant soft tissues, and prosthetic-driven surgical procedure to place implants in a good functional and esthetic position. This therapeutic approach restored function and aesthetics and achieved the outcomes' stability at three years of follow-up.