Intended for Surgeon

Central Giant Cell Granuloma Tumor Resection


Maxillofacial, Patient Specific Guide, Prosthesis

An elderly woman suffering from Central Giant Cell Granuloma had met with a maxillofacial surgeon. She had refused to consent to extract a fibular or iliac graft and, because of this, had not pursued her treatment plan in 2017.
She returned after a year with a significantly larger tumor that had resulted in complete disfiguration and required immediate attendance.

CGCG tumor after one year of not treating the initial tumor

At the request of her surgeon, FJS made an initial design of a customized partial mandibular implant that would replace the resected tumor and alleviate the need for a bone graft. Upon receiving this news, the patient got extremely excited about this novel solution and chose the 3D printed Titanium implant over more conventional treatment plans.

Computer design of the customized mandibular implant

Receiving the go-ahead from both the surgeon and patient, FJS manufactured the prosthesis using Selective Laser Melting (SLM) method and after the necessary secondary operations, it underwent washing and packaging and was sterilized using gamma radiation.

Gamma sterilized customized prosthesis delivered to the Operating Room

A patient-specific surgical guide was used to resect the tumor at the exact resection planes used to design the prosthesis. Having removed the tumor, the customized implant was placed on the remaining jaw bone with ease and was fixed in place using reconstruction screws

Pre-determined suturing points were used to re-attach the geniohyoid muscle to the prosthesis as it was crucial to preserve the patients ability to swallow and talk. Symmetry of the TMJ on both sides was examined and having obtained a satisfactory fixation, the incision was closed.

The patient was able to talk after less than 24 hours postoperatively, and is continuously monitored every 6 months.

Patient 6 months after the surgery