Immediate Teeth in Fibulas: Expanded Clinical Applications and Surgical Technique

Williams, Fayette C.; Hammer, Daniel A.; Wentland, Todd R.; Kim, Roderick Y.

doi:10.1016/j.joms.2021.04.005

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…This "Jaw in a Day" technique, which accomplishes functional jaw and dental reconstruction within a single procedure, is made possible by leveraging emerging technologies including virtual surgical planning and in-house 3D printing. 10,17,19,24,25,28 In this series, we did not attempt "Jaw in a Day" reconstruction. The two patients that received a temporary dental prosthesis did so 12 ± 4 months after jaw reconstruction.…”

Section: Resultsmentioning

confidence: 99%

Free flap jaw reconstruction with dental implantation: A single‐institution experience

Ostrander,

Meller,

Harmon

et al. 2024

Head & Neck

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BackgroundWe sought to review our institution's experience with dental implant placement in free flap jaw reconstruction to determine factors impacting restoration of dental occlusion.MethodsExactly 48 patients underwent free flap jaw reconstruction with or without dental restoration from 2017 to 2022. Primary outcome was achievement of restored dental occlusion after jaw free flap reconstruction.ResultsA total of 48 patients with a mean age of 59.8 ± 16.4 years underwent jaw reconstruction from 2017 to 2022. Ten patients (20.8%) received osteointegrated dental implants. Two patients received a temporary dental prosthesis, 12 ± 4 months after initial reconstruction. Three patients received a final prosthesis, with a mean time to final prosthesis of 17.7 ± 12.4 months. Five patients did not receive any prosthesis despite placement of implants.ConclusionA minority of patients received dental implant placement with free flap jaw reconstruction and only a small subset of these received a definitive dental prosthesis.

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Section: Resultsmentioning

confidence: 99%

Free flap jaw reconstruction with dental implantation: A single‐institution experience

Ostrander,

Meller,

Harmon

et al. 2024

Head & Neck

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“…To our knowledge, there is no literature reporting immediate reconstruction of a total maxillectomy defect with free fibula flap, endosseous dental implants, and prosthesis with full arch restoration of the opposing mandible with dental implants and prosthesis. Following Hirsch's landmark report, investigators focused and streamlining the technique, reducing cost, and efficiency of digital workflows for the procedure, [18][19][20][21] Miloro et al and others added to the protocol with the addition of nerve allografting. 10,22,23 Traditional techniques involved in jaw reconstruction include resection of tumor and reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Immediate Free Fibula Flap After Maxillectomy With Simultaneous Full-arch Dental Implant-Supported Prosthetic Rehabilitation of the Midface and Mandible: The “Super Reconstruction Concept”

Frias,

Al Afif,

Markiewicz

2023

Journal of Craniofacial Surgery

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Immediate reconstruction and dental rehabilitation for ablative defects of the head and neck in one surgery is now a commonly used technique among reconstructive surgeons. Often patients are edentulous or partially edentulous in the jaw opposing that with pathology. In this case, only rehabilitating the dental arch affected by pathology would not render the patient with a functional occlusion. We introduce the “super reconstruction” concept which includes not only rehabilitating the dental arch affected by pathology but also the opposing arch, giving the patient a fully functional occlusion at the time of ablative surgery. This concept is described through a case of a patient with a T4aN0M0 squamous cell carcinoma of the maxilla who underwent total maxillectomy, immediate fibula flap reconstruction of the maxilla with, and full arch dental implant placement into the maxilla and opposing mandible with prosthetic rehabilitation.

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“…9,10 Using a dental laboratory to fabricate the prosthetic teeth increases cost and adds an additional 2-3-week delay. 4 Our group reduces this delay to a few hours by requesting the teeth be printed with the mandibular models already provided by the guide manufacturer. Including the implant holes in the models simplifies the process of adding resin and connecting abutments and can be done in a few hours.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Using a dental laboratory to fabricate the prosthetic teeth increases cost and adds an additional 2–3-week delay. 4…”

Section: Discussionmentioning

confidence: 99%

“…Multiple groups have reported on the use of prefabricated cutting guides made from computed tomography (CT) and dental scan data for jaw resection, fibula harvest, and implant placement. [1][2][3][4] Implant abutments and a dental prosthesis are then attached to aid in positioning of the fibula segment. Although excellent results can be achieved, limitations include the need for (1) increased lead time and cost if outsourcing to a dental laboratory, (2) in-house scanning and 3D printing capabilities, and (3) multiple dental specialists and equipment available intraoperatively.…”

Section: Introductionmentioning

confidence: 99%

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A Simplified Approach to Jaw-in-a-Day Using a Preassembled Prosthesis: Lowering the Barrier to Entry

Tso

Park

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Fibula flap reconstruction with primary dental implant placement has been established as a successful procedure for composite mandibular defects. When using virtual surgical planning, these techniques typically require additional personnel and materials preoperatively and intraoperatively to fabricate occlusal-based guidance and prosthesis. The authors present a technique utilizing a custom-made implant-supported prosthesis completed before surgery that greatly reduces lead time and needed resources. The authors follow the established workflow of segmental mandibulectomy and fibula flap reconstruction using premanufactured cutting guides and placement of dental implants. Cylindrical holes along the implant axes are included in the printed surgical model provided by the guide manufacturer. Acrylic resin and abutments are added to the model to a positioning stent for use during surgery that does not require intraoperative modification before fibula inset. This ensures optimal position for facial esthetics and fixed dental rehabilitation. The presented technique uses printed models already provided by the guide manufacturer, reducing preparation time and requiring fewer personnel and materials intraoperatively. This is an approach to the jaw-in-a-day procedure with a lower barrier to entry that may be used by new craniofacial teams.

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Immediate Teeth in Fibulas: Expanded Clinical Applications and Surgical Technique

Cited by 19 publications

References 16 publications

Free flap jaw reconstruction with dental implantation: A single‐institution experience

Free flap jaw reconstruction with dental implantation: A single‐institution experience

Immediate Free Fibula Flap After Maxillectomy With Simultaneous Full-arch Dental Implant-Supported Prosthetic Rehabilitation of the Midface and Mandible: The “Super Reconstruction Concept”

A Simplified Approach to Jaw-in-a-Day Using a Preassembled Prosthesis: Lowering the Barrier to Entry

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