Download PDF
Facial Plast Surg 2021; 37(06): 722-727
DOI: 10.1055/s-0041-1732478
Original Article

Jaw in a Day: Immediate Dental Rehabilitation during Fibula Reconstruction of the Mandible

Adrian Ong
1   Otolaryngology and Facial Plastic Surgery Associates, Facial Plastic Surgery, Fort Worth, Texas
,
Fayette Williams
2   Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, Fort Worth, Texas
,
Ellen Tokarz
3   Department of Otolaryngology Head and Neck Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
,
Tom Shokri
4   Department of Otolaryngology, Baylor All Saints Medical Center at Fort Worth, Fort Worth, Texas
,
Daniel Hammer
5   Department of Oral and Maxillofacial Surgery, Naval Medical Center San Diego, San Diego, California
,
Yadranko Ducic
1   Otolaryngology and Facial Plastic Surgery Associates, Facial Plastic Surgery, Fort Worth, Texas
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Reconstructing mandibular defects presents challenges to dental rehabilitation related to altered bone and soft tissue anatomy. Dental implants are the most reliable method to restore the lost dentition. Immediate dental implants have been placed for many years but with unacceptably low rates of dental/prosthetic success. Current virtual technology allows placement of both fibulas and guided implants in restoratively driven positions that also allow immediate dental rehabilitation. Inexpensive three-dimensional printing platforms can create provisional dental prostheses placed at the time of surgery. This article reviews our digital and surgical workflow to create an immediate dental prosthesis to predictably restore the dentition during major jaw reconstruction with fibula free flaps.

Keywords

Jaw in a Day - fibula free flap - dental implants - mandible reconstruction - virtual surgical planning


Publication History

Article published online:
11 August 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Urken ML, Buchbinder D, Weinberg H, Vickery C, Sheiner A, Biller HF. Primary placement of osseointegrated implants in microvascular mandibular reconstruction. Otolaryngol Head Neck Surg 1989; 101 (01) 56-73
    CrossrefPubMedGoogle Scholar
  • 2 Rohner D, Jaquiéry C, Kunz C, Bucher P, Maas H, Hammer B. Maxillofacial reconstruction with prefabricated osseous free flaps: a 3-year experience with 24 patients. Plast Reconstr Surg 2003; 112 (03) 748-757
    CrossrefPubMedGoogle Scholar
  • 3 Rohner D, Bucher P, Kunz C, Hammer B, Schenk RK, Prein J. Treatment of severe atrophy of the maxilla with the prefabricated free vascularized fibula flap. Clin Oral Implants Res 2002; 13 (01) 44-52
    CrossrefPubMedGoogle Scholar
  • 4 Jaquiéry C, Rohner D, Kunz C. et al. Reconstruction of maxillary and mandibular defects using prefabricated microvascular fibular grafts and osseointegrated dental implants -- a prospective study. Clin Oral Implants Res 2004; 15 (05) 598-606
    CrossrefPubMedGoogle Scholar
  • 5 Odin G, Balaguer T, Savoldelli C, Scortecci G. Immediate functional loading of an implant-supported fixed prosthesis at the time of ablative surgery and mandibular reconstruction for squamous cell carcinoma. J Oral Implantol 2010; 36 (03) 225-230
    CrossrefPubMedGoogle Scholar
  • 6 Schepers RH, Raghoebar GM, Vissink A. et al. Fully 3-dimensional digitally planned reconstruction of a mandible with a free vascularized fibula and immediate placement of an implant-supported prosthetic construction. Head Neck 2013; 35 (04) E109-E114
    CrossrefPubMedGoogle Scholar
  • 7 Hutchison I, Dawood A. Maxillofacial Treatments. May 2021. Accessed June 28, 2021 at http://www.dawoodandtanner.co.uk/maxillofacial
    Google Scholar
  • 8 Levine JP, Bae JS, Soares M. et al. Jaw in a day: total maxillofacial reconstruction using digital technology. Plast Reconstr Surg 2013; 131 (06) 1386-1391
    CrossrefPubMedGoogle Scholar
  • 9 Qaisi M, Kolodney H, Swedenburg G, Chandran R, Caloss R. Fibula Jaw in a Day: state of the art in maxillofacial reconstruction. J Oral Maxillofac Surg 2016; 74 (06) 1284.e1-1284.e15
    CrossrefPubMedGoogle Scholar
  • 10 Runyan CM, Sharma V, Staffenberg DA. et al. Jaw in a Day: state of the art in maxillary reconstruction. J Craniofac Surg 2016; 27 (08) 2101-2104
    CrossrefPubMedGoogle Scholar
  • 11 Chang YM, Wei FC. Fibula Jaw-in-a-Day with minimal computer-aided design and manufacturing: maximizing efficiency, cost-effectiveness, intraoperative flexibility, and quality. Plast Reconstr Surg 2021; 147 (02) 476-479
    CrossrefPubMedGoogle Scholar
  • 12 Sukato DC, Hammer D, Wang W, Shokri T, Williams F, Ducic Y. Experience with “Jaw in a Day” technique. J Craniofac Surg 2020; 31 (05) 1212-1217
    PubMedGoogle Scholar
  • 13 Khatib B, Cheng A, Sim F, Bray B, Patel A. Challenges with the Jaw in a Day technique. J Oral Maxillofac Surg 2020; 78 (10) 1869.e1-1869.e10
    CrossrefPubMedGoogle Scholar
  • 14 Patel A, Harrison P, Cheng A, Bray B, Bell RB. Fibular reconstruction of the maxilla and mandible with immediate implant-supported prosthetic rehabilitation: Jaw in a Day. Oral Maxillofac Surg Clin North Am 2019; 31 (03) 369-386
    CrossrefPubMedGoogle Scholar
  • 15 Williams FC, Hammer DA, Wentland TR, Kim RY. Immediate teeth in fibulas: planning and digital workflow with point-of-care 3D printing. J Oral Maxillofac Surg 2020; 78 (08) 1320-1327
    CrossrefPubMedGoogle Scholar
  • 16 Williams FC, Hammer DA, Wentland TR, Kim RY. Immediate teeth in fibulas: expanded clinical applications and surgical technique. J Oral Maxillofac Surg 2021; 79 (09) 1944-1953
    CrossrefPubMedGoogle Scholar
  • 17 Attia S, Wiltfang J, Pons-Kühnemann J. et al. Survival of dental implants placed in vascularised fibula free flaps after jaw reconstruction. J Craniomaxillofac Surg 2018; 46 (08) 1205-1210
    CrossrefPubMedGoogle Scholar
  • 18 Wu YQ, Huang W, Zhang ZY, Zhang ZY, Zhang CP, Sun J. Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction. Chin Med J (Engl) 2008; 121 (19) 1861-1865
    CrossrefPubMedGoogle Scholar
  • 19 Gbara A, Darwich K, Li L, Schmelzle R, Blake F. Long-term results of jaw reconstruction with microsurgical fibula grafts and dental implants. J Oral Maxillofac Surg 2007; 65 (05) 1005-1009
    CrossrefPubMedGoogle Scholar
  • 20 Nooh N. Dental implant survival in irradiated oral cancer patients: a systematic review of the literature. Int J Oral Maxillofac Implants 2013; 28 (05) 1233-1242
    CrossrefPubMedGoogle Scholar
  • 21 Ch'ng S, Skoracki RJ, Selber JC. et al. Osseointegrated implant-based dental rehabilitation in head and neck reconstruction patients. Head Neck 2016; 38 (Suppl. 01) E321-E327
    CrossrefPubMedGoogle Scholar
  • 22 Sandoval ML, Rosen EB, Robert AJ, Nelson JA, Matros E, Gelblum DY. Immediate dental implants in fibula free flaps to reconstruct the mandible: a pilot study of the short-term effects on radiotherapy for patients with head and neck cancer. Clin Implant Dent Relat Res 2020; 22 (01) 91-95
    CrossrefPubMedGoogle Scholar
  • 23 Smolka K, Kraehenbuehl M, Eggensperger N. et al. Fibula free flap reconstruction of the mandible in cancer patients: evaluation of a combined surgical and prosthodontic treatment concept. Oral Oncol 2008; 44 (06) 571-581
    CrossrefPubMedGoogle Scholar
  • 24 Schepers RH, Slagter AP, Kaanders JH, van den Hoogen FJ, Merkx MA. Effect of postoperative radiotherapy on the functional result of implants placed during ablative surgery for oral cancer. Int J Oral Maxillofac Surg 2006; 35 (09) 803-808
    CrossrefPubMedGoogle Scholar
  • 25 Pellegrino G, Tarsitano A, Ferri A, Corinaldesi G, Bianchi A, Marchetti C. Long-term results of osseointegrated implant-based dental rehabilitation in oncology patients reconstructed with a fibula free flap. Clin Implant Dent Relat Res 2018; 20 (05) 852-859
    CrossrefPubMedGoogle Scholar