Microvascular free tissue transfer has been one of the greatest milestones in reconstruction of the mandible and maxilla after tumor ablative surgery. Although fibula free flap reconstruction allows for immediate bony reconstruction, dental rehabilitation usually requires 6 to 12 months before it is completed. This can have a serious psychological impact on patients because they go without teeth during this timeframe. The "jaw-in-a-day" procedure was previously described by a group at New York University Medical Center. It allowed for tumor removal and full jaw reconstruction and dental rehabilitation in 1 surgery. This report describes 3 patients treated with this novel technique and adds to the 4 cases previously reported in the literature. To their knowledge, the authors are the second group to report on this technique. A series of photographs and videos are referenced in this article to illustrate the different steps used in this procedure.

Seventeen patients treated for acute lymphoblastic leukemia by combination chemotherapy before their reaching 10 years of age were studied for altered dental root development of their premolar teeth. Five of the 17 patients showed subjective radiographic evidence of marked shortening of the premolar dental roots; 13 had thinning of the roots. A quantitative analysis was developed and verified, which disclosed a 63.33% to 84.38% reduction of premolar root length when compared with the mean of the historical controls. With recent significant increases in long-term survival rates of children with malignancies, altered dental development becomes an important factor to follow years after chemotherapy is discontinued. The findings of these chemotherapy-associated dental development changes impacts on the patient's quality of life and also can serve as a research tool to assess permanent effects of chemotherapy on normal tissue growth and development.

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CONCLUSIONSCutaneous squamous cell carcinoma of the head and neck often requires resection, creating significant cosmetic defects. In patients who are otherwise not suitable for surgical reconstruction, osseointegrated implants and prosthetic rehabilitation should be considered. This case shows that the use of such techniques can provide excellent function and cosmetic outcomes. CASE PRESENTATIONA 66 yo Caucasian male was diagnosed with a T 4 N 0 M 0 squamous cell carcinoma of the nasal dorsum. Multiple biopsies were taken to map out the extent of the tumor yielding the need for a total rhinectomy. The patient was felt to be a poor surgical reconstructive candidate due to multiple medical comorbidities including vascular insufficiency precluding local or regional flap reconstruction. Prosthetic reconstruction was completed using osseointegrated implants and an implant-retained nasal prosthesis. DISCUSSION Cutaneous squamous cell carcinoma is one of the most common malignancies of the head and neck and advanced disease of the nasal skin is not uncommon. A near-total or total rhinectomy is often needed to achieve complete resection of the disease.Reconstruction is commonly accomplished with cartilage grafts and flap reconstruction, most commonly paramedian forehead flaps or microvascular free tissue transfer. However, some patients' overall medical condition or vascular status makes them ineligible for these procedures.In this case, the patient was fitted with osseointegrated implants in the maxilla. The second stage was delayed for five months to allow for complete osseointegration. The patient then had the abutments and gold crossbar placed as shown. The implantretaining prosthesis was then placed resulting in an excellent cosmetic result.