In April 2013, a life-saving transplant operation was performed in Gliwice
In April 2013, then 33-year-old Grzegorz Galasiński had a serious accident at work, as a result of which he lost most of his face. In May, at the Oncology Center – Instytut im. Maria Skłodowskiej-Curie in Gliwice, doctors under the supervision of prof. Adam Maciejewski’s face was transplanted from a deceased donor. It was the first such operation in Poland and the first life-saving face transplant in the world – the patient’s injuries were so extensive that in the long run they were life-threatening.
Even then, prof. Maciejewski signaled that rehabilitation and further treatment would be necessary. One of its key stages was the reconstruction of the dentition.
The tasks were undertaken free of charge by a team of specialists – Dr. Bartosz Nowak and Dr. Maciej Nowiński from Prodenta Clinic in Katowice, in cooperation with Dr. Krzysztof Gronkiewicz and the technician Artur Nitkiewicz. The procedure was performed at the end of May 2014 at the Oncology Center in Gliwice, more than a year after the face transplant and immediately after another reconstructive surgery performed by the team of prof. Adam Maciejewski.
Only now, more than 1,5 years after the procedure, specialists can talk about full success. Previously, there was a risk that the implants would not catch on. “We can already breathe a sigh of relief. The implants have fused with the transplanted jaw and the reconstructed lower jaw, and the patient has had new teeth for several weeks. We waited a long time for this effect. There was a risk that the body would reject the titanium screws and not fuse with the bone. In addition, we had to monitor the patient’s condition all the time in terms of potential infections, ”said Dr. Maciej Nowiński, a specialist in maxillofacial surgery from Prodenta Clinic on Wednesday.
The procedure was a challenge because it had never been performed in a jaw transplanted from a donor, in a mandible fused up to 10 pieces, in a patient with a disabled immune system. “There was no such case in any professional literature. It was like a flight to Mars, you had to plan everything from scratch “- emphasized Dr. Nowiński.
In 1,5 hours, dentists had to implant as many as 12 titanium implants – 6 in the fused jaw and 6 in the transplanted jaw. For this purpose, they used Biomet 3i implants imported from the United States, which have a special osseointegrator coating that accelerates the process of titanium fusing with the bone. Before the dentists went to work, computer simulations were necessary.
«We subjected the patient to complex diagnostics. We performed a series of tomography to plan the entire treatment by computer using 3D technology. Therefore, the procedure was preceded by a series of virtual simulations during which we determined how the implants should be positioned. It was necessary due to the extreme medical conditions and the patient’s situation »- explained the prosthetist Dr. Bartosz Nowak.
The period of healing and healing after the procedure was about a year, usually about 6 months. Only after this time, the implants were exposed. Then the prosthetists started working. “As traditional crowns and bridges turned out to be too heavy for the patient, two prostheses were mounted on special beams. It was created by the milling center in Valencia, one of the best in the world, ”said Dr. Krzysztof Gronkiewicz, a prosthetist.
Today, more than 1,5 years after the first dental procedure, the patient can speak, eat and smile more clearly. “This was also the aim of the procedure, to restore the proper function of the stomatognathic system, which includes teeth. For Grzegorz, the implants implanted in the bone are imperceptible, just like the prostheses that have been adjusted to the specific anatomy of the patient’s oral cavity “- added Dr. Nowak.