Jaw in a day surgery: early experience with 19 patients at an Australian tertiary referral center

• Published in: ANZ journal of surgery 2024-09, Vol.94 (9), p.1531-1538
• Main Authors: Jeong, Yu Jin, Dunn, Masako, Manzie, Timothy, Howes, Dale, Wykes, James, Palme, Carsten E., Leinkram, David, Low, Tsu‐Hui (Hubert), Oberoi, Ramman, Aung, Yee Mon, Ormsby, Christopher, Clark, Jonathan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ameloblastoma; Ameloblastoma - surgery; Australia; bone transplantation; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; computer‐assisted; Dehiscence; Dental prosthetics; Early experience; Female; free tissue flaps; Hematoma; Humans; Implants; Jaw; Jaw Neoplasms - radiotherapy; Jaw Neoplasms - surgery; Male; mandibular reconstruction; Maxillofacial; Middle Aged; Occlusion; Plastic Surgery Procedures - methods; Postoperative Complications - epidemiology; Prostheses; prosthesis implantation; Radiation therapy; Reconstructive surgery; Retrospective Studies; Squamous cell carcinoma; surgery; Tertiary Care Centers; Time measurement; Transplants & implants; Treatment Outcome; Wound infection
• ISSN: 1445-1433; 1445-2197; 1445-2197
• DOI: 10.1111/ans.19203

Background The Jaw‐in‐a‐Day (JIAD) procedure aims to achieve immediate functional occlusion via a single‐stage approach to maxillofacial reconstruction. While JIAD has gained popularity since its inception by Levine and colleagues, efficacy and outcome data remain limited. In this report, we discuss our experience with the JIAD technique at an Australian tertiary referral centre. Methods A retrospective review of all JIAD procedures performed from April 2022 to December 2023 was conducted. Clinicopathologic data reviewed included demographic information, primary diagnosis, anatomical site of disease, and history of pre‐operative radiotherapy. Outcome measures of interest included operative time, number of implants placed, post‐operative complications and implant survival. Results Nineteen patients were identified for the study. Two maxillary and 17 mandibular JIAD procedures were performed. The most common indications were squamous cell carcinoma (n = 8) and ameloblastoma (n = 5). Surgical complications included recipient site wound infection (n = 3), flap dehiscence (n = 2), haematoma formation (n = 1), and neck abscess associated with partial flap failure (n = 1). No total flap failures were identified. Of the 55 total implants placed, one implant failure occurred 2‐months post‐operatively. No loss of irradiated implants (n = 21) was observed. The median time to adjuvant radiotherapy was 57 days (range, 32–61). Eighteen of 19 patients (95%) achieved immediate dental rehabilitation, and 15/19 patients (79%) retained a functional prosthesis by the end of the follow‐up period. Conclusions Our series supports the feasibility of single‐stage reconstruction for both benign and malignant indications. Further research is required to understand the long‐term functional, aesthetic, and health‐related quality‐of‐life outcomes with the JIAD technique. In this case series, we discuss our early experience with the Jaw in a Day (JIAD) technique at an Australian tertiary referral centre. Our research demonstrates that the JIAD procedure predictably achieves immediate dental restoration in patients undergoing major maxillofacial reconstruction, and supports the feasibility of its use for both benign and malignant indications.