Fibular Reconstruction of the Maxilla and Mandible with Immediate Implant-Supported Prosthetic Rehabilitation: Jaw in a Day

Ashish Patel; Phillip Harrison; Allen Cheng; Brian Bray; R Bryan Bell

doi:10.1016/j.coms.2019.03.002

Fibular Reconstruction of the Maxilla and Mandible with Immediate Implant-Supported Prosthetic Rehabilitation: Jaw in a Day

Oral Maxillofac Surg Clin North Am. 2019 Aug;31(3):369-386. doi: 10.1016/j.coms.2019.03.002. Epub 2019 Jun 1.

Authors

Ashish Patel¹, Phillip Harrison², Allen Cheng³, Brian Bray⁴, R Bryan Bell⁵

Affiliations

¹ The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA. Electronic address: https://twitter.com/PatelMDDDS.
² The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA.
³ The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA.
⁴ The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Private Practice, Portland Prosthodontics, 5050 Northeast Hoyt Street, Suite 640, Portland, OR 97213, USA.
⁵ The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA. Electronic address: richard.bell@providence.org.

PMID: 31164268
DOI: 10.1016/j.coms.2019.03.002

Abstract

The fibula free flap is a workhorse flap used to reconstruct ablative, osseous defects in the upper and lower jaws. Traditionally, the fibula free flap is inset into the defect freehand; dental implants are placed secondarily; and final prosthetic rehabilitation often occurs more than 1 year after ablative surgery. Virtual surgical planning and rapid prototyping of cutting guides and guide stents for head and neck reconstruction have facilitated improved accuracy in fibular transfer. This article describes the Jaw in a Day technique, allowing maxillary or mandibular resection, fibular free flap reconstruction, immediate implant placement, and prosthetic rehabilitation in a single operation.

Keywords: Endosseous implants; Free fibula flap; Immediate reconstruction; Jaw in a Day; Mandibular reconstruction; Maxillary reconstruction; Virtual surgical planning.

Publication types

Review

MeSH terms

Bone Transplantation / methods*
Dental Implants*
Fibula / transplantation*
Free Tissue Flaps / blood supply*
Humans
Mandible / surgery*
Mandibular Reconstruction / methods*
Maxilla / surgery*
Plastic Surgery Procedures / methods

Substances

Dental Implants