Abstract
The free fibula flap has transformed mandibular reconstruction, evolving from simply
for bone defect reconstruction to including immediate dental rehabilitation and from
a staged to a simultaneous procedure. This paper chronicles the progression from delayed
implant placement to the modern-day single-stage “jaw in a day” (JIAD) procedure,
enabled by advances in CAD/CAM (computer aided design/computer aided manufacturing)
technology, virtual surgical planning, and digital prosthesis. Pioneering work contributing
to fibula–jaw reconstruction and rehabilitation from Chang Gung Memorial Hospital
is also highlighted. The anatomical study of the fibula osteoseptocutaneous flap makes
its clinical application also possible when simultaneous skin/mucosal coverage is
needed. The early and vast experience of secondary and primary dental implantation
has allowed us to develop and advocate for the “jaw during admission” after several
initial attempts at JIAD reconstruction. In this approach, the dental prosthesis is
delayed to the day before discharge from the hospital after confirming the success
of the transferred fibula. It not only avoids an unnecessary step in complicated fibula
flap transfer procedures, but in case of failure, it also mitigates logistical and
technical challenges of prosthesis conversion, while maintaining the benefits of immediate
dental implant restoration. This review also examines current evidence surrounding
implant success, complications like osteoradionecrosis, and outcomes in malignant
versus benign cases.
Keywords
jaw-in-a-day - jaw during admission - fibula free flap - dental implants
