Summary:

Implant-free rehabilitation of complex facial and cervical defects remains a major challenge in surgical prosthetics and anaplastology. Particularly in cases involving sensitive anatomical conditions or limited surgical options, individualized retention and treatment concepts are required to achieve functionally stable and clinically practical outcomes.

Using two clinical case examples – a tracheostoma rehabilitation and a nasal epithesis following tumor resection – this presentation demonstrates how implant-free defect reconstructions can be realized through individualized model optimization.

In the first case, surgical repositioning of the trachea prevented the use of a conventional impression with a standard cannula, as this would have significantly deformed the anatomy and compromised the accuracy of the final prosthetic fit. Instead, CT imaging data were used for digital reconstruction and optimization of the epithesis geometry.

In the second case, partial resection of the nasal concha resulted in a complex, partially closed defect in which conventional impression techniques were considered unsafe. Here as well, CT imaging served as the basis for digital modeling of the epithesis.

These cases demonstrate that digital imaging techniques can provide valuable support in the planning and realization of implant-free defect rehabilitation. Especially in anatomically complex situations, such approaches allow for functionally optimized and patient-specific treatment solutions without implant-retained fixation.