Maxillofacial fibrous dysplasia—diagnosis, treatment and reconstruction with a personalized, 3D-printed titanium implant: a case report

Fibrous dysplasia is a rare disease belonging to benign, noncancerous bone and fibrous-related developmental disorders. A 34-year-old male was admitted to the maxillofacial surgery unit to diagnose a rapidly growing, painless lesion with swelling in the right buccal region and increasing facial deformity for three months. Computed tomography (CT) images revealed an inhomogeneous, ill-defined lesion in the maxilla and maxillary sinus. Despite the lesion, the patient had no clinically significant neurological abnormalities. The lesion was diagnosed as fibrous dysplasia on the basis of preoperative tissue biopsy. The treatment of choice was complete surgical excision with immediate reconstruction and fixation of the orbital floor by implanting an alloplastic titanium mesh implant. Then, the patient underwent a secondary reconstruction of tissue defects using a personalized, 3D-printed titanium implant. Reconstruction of postresection defects covering a large craniofacial area is a challenge for maxillofacial surgeons due to the specific location of the face, especially considering psychological and technical aspects. The reconstruction method should be predictable and safe and should guarantee the best aesthetic effect, close to perfection. The ideal solution seems to be the use of an individually prepared, personalized 3D-printed titanium implant with anatomical detail mapping, which can perfectly recreate the missing tissues.