Facial Trauma with Total Maxillectomy and Z-Pillar Rehabilitation: A Case Report

Aims: Facial trauma is one of the leading causes of mortality that affects young male adults. It has a multifactorial etiology, and the predominant causes are motor vehicle accidents (MVAs) and physical assault. Maxillectomy is a surgical procedure, partial or total removal of the jaw, either due to trauma or pathology (oral cancer). The surgical defect created can cause psychological, functional, and aesthetic disorders for the patient, making rehabilitation essential.

Case Presentation: This case report is about a 45-year-old Caucasian patient who was a victim of facial trauma due to an MVA and underwent three hospital surgeries. Prosthetic rehabilitation was done using conventional implants anchored in zygomatic bones associated with the Z-pillar (Facco Technique). It is a rehabilitative treatment option for total maxillectomy, as it restores aesthetics and function to the patient.

Discussion: Facial trauma represents almost 9% of emergency care in Brazil's hospitals, and among the leading causes are MVAs, as occurred in the present Case Report. Maxillectomy is classified into three types: 1) with preservation of the orbital floor, 2) with loss of orbital support, and 3) with orbital exenteration and ethmoidectomy, as occurred in right side in this Clinical Case Report. The Facco Technique was performed in three stages (conventional implant, intermediate 18-mm-long piece, and 15-mm-long piece). Subsequently, the component's mini pillar was installed.

Conclusion: It can be concluded that conventional implants installed in the zygomatic bone and using the Z-pillar (Facco Technique) were a great option to rehabilitate patients who were victims of a MVAs without maxilla and reduced his treatment time. It also gave him a new chance to find his way back into society and improved his quality of life.