Long-term outcomes of CAD/CAM monocompartmental condyle prosthesis supporting bone transplant after mandible resection

Condylar reconstruction and replacement with alloplastic materials have gained increasing surgical interest due to their critical role in restoring mandibular function. This study aimed to evaluate clinical outcomes and long-term complications in patients undergoing computer-aided design/computer-aided manufacturing (CAD/CAM) condylar reconstruction following mandibular resection-disarticulation. Twenty patients were treated for benign or malignant mandibular tumors involving the condylar region. In all cases, the articular meniscus was preserved, and reconstruction was performed using a CAD/CAM plate supporting a bone free flap or graft. The prosthetic condyle was designed to replicate the native anatomical morphology. Clinical evaluation focused on occlusal stability, mandibular function, and pain, while radiographic and CT follow-up assessed plate integrity and positioning. The mean follow-up was 46 months (with a minimum follow up of 8 and maximum of 152 months) No cases of plate exposure, loosening, or joint pain were observed. CT scans showed no evidence of glenoid fossa resorption. Preoperative occlusion was maintained in all dentate patients. Two cases of condylar displacement occurred due to intraoperative malpositioning, and two prosthesis fractures were detected during radiological follow-up, in absence of associated symptoms. Overall, this study demonstrated favorable long-term outcomes, with good functional recovery and a low rate of complications.