Subperiosteal anchorage for craniofacial epitheses: technical innovation with an illustrative nasal application.
A Battisti, G Pagnani, V Pallini et al.
✦ AI-curated · Sources linked
Case in brief
A 68-year-old woman with xeroderma pigmentosum had multiple nasal and upper-lip carcinomas, leaving complete arhinia and loss of premaxillary support. These defects made free-flap reconstruction and predictable endosseous implant placement infeasible, while conventional epithesis retention was unreliable. CT-based virtual planning and biomechanical simulation guided fabrication of a patient-specific, 3D-printed titanium subperiosteal framework, secured with seven screws and connected to a bar-clip silicone nasal epithesis. Loading began at 1 month. At 12 months, healing was uneventful, with no device-related complications or loss of retention; the patient reported high acceptance and improved self-confidence.
What made this case unusual
The patient-specific juxtaosseous framework provided an alternative anchorage strategy when both conventional retention and endosseous implants were unsuitable because of extensive nasal and premaxillary loss.
Diagnostic / clinical pearl
When anatomy precludes predictable endosseous implant placement, a CT-planned, patient-specific subperiosteal framework may provide an external retention interface for a craniofacial epithesis.