case_images: PMC11832267_01
case_images: (a) Aspect of the lesion consulted by the patient. We observe the whitish outgrowth areas and how it is introduced under the prosthesis, so we proceed to lift the crowns. (b) X-ray 6 months before the debut of the lesion. (c) Panoramic x-ray on removal of the prosthesis showing bone loss, which may initially suggest peri-implantitis.
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case_images: fig1
case_images: An excrescent lesion which followed the gingival contour with whitish areas and a tendency to bleed was observed in the same quadrant (Figure 1(a)). In a previous x-ray taken 6 months prior to the onset of the lesion, the mesial bone loss for the implant in Position 34 was recorded at 0.88 and 1.05 mm distally, while for the implant in Position 36, the mesial bone loss was only 1.59 mm and the distal bone loss was 1.18 mm (Figures 1(b) and 1(c)).
case_images: Image of the lesion 20 days after waiting for the histological examination results, confirming the presence of oral squamous cell carcinoma. Lateral view shows the lesion extending along the gingival margin.
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case_images: fig2
case_images: During this period, the patient's condition deteriorated significantly; the lesion progressed to an irregular ulcer with poorly defined borders and areas of erythroplasia (Figure 2).
case_images: X-ray of the patient with the osteosynthesis plate at the end of the surgery (6 months after resection surgery).
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case_images: fig3
case_images: The reconstruction of the mandible was achieved by microvascularized peroneal flap and fixation with an osteosynthesis plate (Figure 3). The bone graft was consolidated into the mandible; the osteosynthesis plate was removed (Figure 3).
case_images: X-ray with bone consolidation and after removal of the osteosynthesis plate (2.5 years after surgery).
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case_images: fig4
case_images: Six months after the surgery, the skin graft was integrated into the oral mucosa (Figures 4 and 5).
case_images: (a) Intraoral images of the patient after surgery with the graft consolidated and healed (6 months after resection surgery). (b) Appearance of the consolidated skin graft on the oral mucosa at higher magnification.
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case_images: fig5
case_images: Six months after the surgery, the skin graft was integrated into the oral mucosa (Figures 4 and 5).
case_images: X-ray after placement of the implants and the immediately loaded provisional prosthesis (2.5 years before surgery).
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case_images: fig6
case_images: A partial prosthesis with mesial cantilever into the third quadrant was delivered (Figure 6).
case_images: (a) Definitive prosthesis placed in the patient, after 6 months of progressive loading with the initial immediately loaded prosthesis. (b) Image of a smile with the definitive prosthesis.
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case_images: fig7
case_images: Two implant-supported prostheses were placed in the maxilla to restore bilateral partial edentulism (Figure 7).
case_images: Panoramic radiograph after placement of the definitive prosthesis with the extension to the third quadrant (3 years after surgical resection).
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case_images: fig8
case_images: Two new prostheses were delivered to restore the edentulous span between the two lateral incisors and the span located distal to the upper left lateral incisor (Figure 8).
case_images: Implant placed in Position 22 to subsequently extract the remaining teeth and make a complete upper prosthesis with the implants already placed previously. Five years have now passed since the surgery to treat oral squamous cell carcinoma.
case_images: CRID2025-5548590.009.jpg
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case_images: fig9
case_images: For the implant in Position 44#, the mesial bone loss was 0.2 mm and distal 0.40 mm, and for the implant in Position 46#, the mesial bone loss was 0.20 mm and distal 0.30 mm (Figures 9, 10, and 11).
case_images: (a) Patient at 10 years of follow-up with definitive upper and lower prostheses. (b) Image of the patient's smile at the end of the follow-up.
case_images: CRID2025-5548590.010.jpg
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case_images: fig10
case_images: For the implant in Position 44#, the mesial bone loss was 0.2 mm and distal 0.40 mm, and for the implant in Position 46#, the mesial bone loss was 0.20 mm and distal 0.30 mm (Figures 9, 10, and 11).
case_images: X-ray at 10 years of follow-up with the stability of both the upper and lower implants, as well as the bone grafted in the mandible as can be seen where it is no longer possible to differentiate the points of union to the original mandible.
case_images: CRID2025-5548590.011.jpg
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case_images: fig11
case_images: For the implant in Position 44#, the mesial bone loss was 0.2 mm and distal 0.40 mm, and for the implant in Position 46#, the mesial bone loss was 0.20 mm and distal 0.30 mm (Figures 9, 10, and 11).