Fibula Jaw-during-Admission

Yang Ming Chang, Chi Ying Tsai, Fu Chan Wei*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Background: Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations and challenges for further pursuit. We propose Fibula Jaw-during-Admission (JDA) as a solution. Materials and methods: From 2019 to 2021, six patients received fibula “Jaw-during-Admission.” Segmental mandibulectomy, fibula transfer, and immediate dental implantation were performed simultaneously during a single surgery. Intraoral scans were used to fabricate temporary light occlusion contact dental prostheses while on the ward prior to discharge during the first and second week post operation. The prostheses were installed before discharge and changed to permanent ones with normal occlusal contact in the clinic at about six months after X-ray confirmation of bone healing. Results: All six surgeries succeeded. Four patients received palatal muco-periosteal graft after debridement of peri-implant overgrown granulation tissue. Follow-up ranged from 12 to 34 months (average 21.2 months) and revealed good function and appearance in all patients. Conclusion: Fibula JDA is superior to the Fibula JIAD approach for simultaneous mandibular reconstruction with fibula and dental rehabilitation. There is no need for postoperative intermaxillary fixation. The surgery can be performed more reliably with less stress. It provides an additional opportunity for dental rehabilitation if initial dental prosthesis installation during JIAD fails. Postreconstruction intraoral scans provide greater precision and more flexibility in milling dental prosthesis which are mapped to the reconstructed mandible during the postoperative period.

Original languageEnglish
Pages (from-to)247-254
Number of pages8
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume82
DOIs
StatePublished - 07 2023

Bibliographical note

Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Keywords

  • Fibula Jaw-during-Admission
  • Fibula Jaw-in-a-Day
  • Segmental jaw defect
  • Mandibular Reconstruction
  • Humans
  • Mandible/surgery
  • Plastic Surgery Procedures
  • Bone Transplantation
  • Fibula/transplantation
  • Dental Implantation, Endosseous
  • Mandibular Osteotomy
  • Free Tissue Flaps/surgery

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