PMC7280476_01
A 4-year-old child presenting with a fast growing tumor (circled in all panels) of the anterior maxilla. (A) Front view of patient, smiling. (B) Magnetic resonance imaging (MRI) of the head, midsagittal plane. (C) MRI of the head, coronal plane.
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F1
A child who was born on April 11, 2007 presented with a mass that developed over a 2-month period (Figure 1) prior to the initial consultation.
Double-structure denture fixed on two subperiosteal implants. (A) Primary structure with LOCATOR precision attachments. (B) Split overdenture.
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F2
The left and right implants were additively manufactured in titanium (Layerwise Inc., Leuven, Belgium) and paired with LOCATOR precision attachments (Figure 2).
The two subperiosteal implants. (A) Posterior view of the stereolithographic defect model with the left subperiosteal implant abutting vertically on the palatal shelf. (B) Right subperiosteal replacement implant, now also abutting vertically (yellow circle), albeit on a very small portion of the maxilla.
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F3
One year later, the right implant loosened and was replaced by a new one on February 4, 2013 (Figure 3). The replacement implant was designed to incorporate such features (Figure 3B).
PMC7280476_02
PMC7280476_03
Front views of patient, smiling, during the years (A) 2014, (B) 2015, (C) 2016, (D) 2017, (E) 2018, and (F) 2019. Flaws in the vertical midface and differences in the distance between the top and bottom eyelids have become apparent during the secondary growth spurt.
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F4
The patient had the secondary structure containing artificial front teeth replaced four times over 6 years (2015, 2016, 2018, and 2020) because of the development of an anterior cross-bite (Figure 4).