Dr. Allen Cheng Dr. Ashish Patel and Dr. Baber Khatib are contributing authors on a recent article regarding the Jaw in a Day® (JIAD) procedure, which includes the largest published case series ever for this type of procedure. It is currently being published in the Journal of Oral and Maxillofacial Surgery. Below are the highlights of the article written by our three doctors:
Purpose
The Jaw in a Day® (JIAD) procedure allows for complete primary reconstruction of bone and teeth at the same operation as tumor resection. We review 12 cases, the largest published case series of the JIAD procedure, and discuss both the prosthodontic and surgical considerations.
Methods
A multi-institutional retrospective chart review was completed to identify patients undergoing JIAD. Subjects with a minimum of 6 months follow-up were included. Variables included skeletal relationship, dental Angle classification changes, post-operative diet, prosthesis complications, flap failure, osseointegration of dental implants, hardware complications, infection, intelligible speech and patients’ subjective satisfaction of their facial and dental esthetics.
Results
The sample included twelve patients, mean age 38 years, (15-75 years, 8 men, 4 women) with an average follow up of 19 months (7-42 months). Patients underwent the JIAD procedure at the same time as resection of an ameloblastoma (9 mandibular,1 maxillary) or odontogenic myxoma (1 mandibular, 1 maxillary). Nine subject’s Angle classification remained unchanged after the procedure, with three corrected from a dental class III to a class I. There was an average of four (range 2-6) implants placed. Hybrid/splinted crown prostheses replaced, on average, 8 teeth (range 3-12) with no prosthetic fractures. All subjects had viable fibula flaps, absence of infection, and completely intelligible speech. All but one patient had subjective satisfaction with their facial and dental esthetics. Complications included plate fracture with fibrous union (1), premature contacts requiring occlusal equilibration (2), implant loss (1), delayed wound healing (1), heterotopic bone formation along the pedicle (1) and dissatisfaction with chin symmetry (1).
Conclusion
The JIAD technique predictably reconstructs bone and teeth in a single surgery. The tools and services streamlining this protocol are now widely available. However, there are still several challenges that surgeons and patients must overcome with this protocol. Further study and refinements are necessary to address these.
Resources: Offical Article Located HERE.
