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I agree. This hardware is relatively new to the U.S. market, introduced in 2023, so we still have limited knowledge about potential complications. I anticipate mucositis may form around the piers, similar to traditional dental implants. However, the advantage is that the piers are positioned away from the osteointegration sites. I expect the main complications might involve hardware exposure due to inadequate soft tissue coverage, particularly in patients undergoing postoperative radiation therapy. Careful patient selection will be critical until we have more data.

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Hi. Thank you for your question. For mandible, I would not recommend it as a reconstruction option for segmental mandibulectomy. I recently did a case where pt failed conventional dental implants (implant infection) in fibula for mandible recon. We removed remaining dental implants and old reconstruction plate and placed mandible ips implant on fibula after it had fully fused (1 yr later). Mandible ips implant have extreme precision with the way it fit around the fibula (neo mandible). As such, in my mind, for mandible, it can be done as a two stage approach. First surgery with fibula/scapula with recon plate and second surgery with ips mandible. Also, mandible is exposed to much greater force than posterior maxilla so I would still consider placing vascularized bone instead of relying just on ips hardware for segmental defect. With greater advancement in technology, such might be possible one day but at this time, I would not recommend ips+radial ff for segmental mandibulectomy recon. If there is no segmental mandibulectomy defect but if mandible continuity is preserved (atrophic mandible, partial mandibulectomy), then ips implant maybe a good option with radial ff being used for mucosal defect along mandible. I hope that makes sense. I am working on my current treatment algorithm for mandibulectomy and maxillectomy that includes ips so you might find that helpful. Hopefully it will be completed within next 1-2 months. Thanks.

Thank you very much for your detailed views on Mandible Psi . I too have failed with mandible psi in an ameloblastoma case in which the psi was designed along with protruding implants . I really agree with your concept of Psi in marginal mandibulectomy cases and as a second stage procedure. Thank you

I am interested in being a member of Reconstruct face . I tried a lot to register but could not as I want access to all videos . Kindly help to get the membership . Thank you

​@@manjunathnm5662 please go to reconstructface.com/contact/ and ask for beta account access. Not all the surgical procedures have been created yet so the surgical library is being added as the lectures are ready but as a beta tester you can get early access before the public release.

Thank you sir

Thank you! More to come...

Thank you for your kind words.

Thank you for your suggestion. I will work on a video that explains 3 major different types that I use routinely (IMFS screw, hybrid arch bar, and traditional archbar) and when I prefer to use them. Here is one video where IMF screws are being applied. th-cam.com/video/-xHUXhlqvbw/w-d-xo.htmlsi=vF-ehuVVVm0yl7sU

You can check out my two other videos on this topic. When it comes to neck dissection, first step is learning anatomic relationships. Check out my neck dissection surgical anatomy (201) course. Once you know what is next to adjacent structure, you can get good at doing difficult neck dissection cases like radiated or previously dissected neck in revision cases. The first step is know the anatomy cold and not worry about structures that are in different levels. Meaning if you are at level 2, don't worry about phrenic nerve or brachial plexus. It is totally different location. Think of it in layers (superficial to deep) and what is within a particular level. There are only a few things (2-4 things) you need to find find at each level so it makes it easy to digest. Lastly, don't use sharp instruments starting out. I know a lot of videos show using scalpel for dissection. If you are starting out, it is better to use metz scissors or something with blunt tip to avoid unnecessary injuries to critical structure. I do 99% of soft tissue dissection with metz scissors. And lastly, just do more of it. First two yrs when you do it on your own is when you really learn. I will add more complex cases (revision neck, radiated neck dissection case) in future videos. Thanks for watching.