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Figure 1. Protocol workflow for maxillomandibular ablation, immediate reconstruction with microvascular free flap, and immediate
dental implant and prosthesis placement.
stone cast respectively. In the case of a conventional impression and stone cast, an additional step to digitize
the cast via laboratory scan is necessary. If the patient has an edentulous area, a digital or conventional wax-
up (emulation of tooth form and position with wax) will be done and uploaded to VSP for treatment
planning purposes [Figure 2].
Provisional prosthesis fabrication
Following VSP, a provisional restoration will be fabricated from polymethyl methacrylate (PMMA) with the
proposed DI position in consideration. The provisional restoration will be milled from a PMMA block for
adequate structural strength with a convex hygienic design. During the operation the provisional prosthesis
will be engaged to the DIs for optimal occlusal alignment and then disengaged for polishing. Following
completion, the provisional prosthesis will be engaged to the DIs for delivery.
