Rebuilding a Jaw in a Day Skip to main content Close Select your preferred language English عربى 简体中文 繁體中文 فارسي עִברִית 日本語 한국어 Русский Español Tagalog Menu Close Call 1-800-CEDARS-1 toggle search form Close Los Angeles, 27 April 2022 07:01 AM America/Los_Angeles Rebuilding a Jaw in a Day Before: This patient's CT scan shows severe tissue death of the lower jaw on the right side, which eventually fractured the jaw. X-rays courtesy of Los Angeles Center for Oral & Maxillofacial Surgery. This patient's CT scan shows severe tissue death of the lower jaw on the right side, which eventually fractured the jaw. After: This CT scan shows the jaw newly reconstructed using "jaw in a day" procedure, where the fibula bone from the lower leg is fitted with dental implants and teeth and transplanted to the jaw in one surgery. This CT scan shows the jaw newly reconstructed using "jaw in a day" procedure, where the fibula bone from the lower leg is fitted with dental implants and teeth and transplanted to the jaw in one surgery. Cedars-Sinai Surgeons Restore Jawbones—Complete With Dental Implants—to Ill or Injured Patients in a Single Procedure Patients who lose a part of their jaw—whether from injury, infection, disease, or as a side effect of cancer treatment—can have the missing jawbone replaced through reconstruction. But most are left with a life-altering dilemma: Their new jaw is missing its teeth. That isn’t the case, however, for those treated by Cedars-Sinai’s “jaw-in-a-day” team. The team—a partnership between Cedars-Sinai and the Los Angeles Center for Oral & Maxillofacial Surgery—is one of just a handful across the country performing a relatively new procedure where patients receive a jaw replacement complete with dental implants in one surgery. “People who have a traditional jaw reconstruction get a new jawbone, but it isn’t very functional,” said oral/maxillofacial surgeon Steven Kupferman, DMD, MD. “The jaw is meant to talk and chew, and without teeth, it can’t do those things as well.” A Tricky Reconstruction In the traditional jaw-replacement procedure—called fibula free flap surgery—the surgeon replaces the damaged jawbone with a section of bone cut from the fibula, the outer bone in the lower leg, which can be removed without compromising the patient’s ability to walk. It is possible for patients to have dental implants added to the jaw in a separate procedure, but head and neck surgeon Jon Mallen-St. Clair, MD, PhD, who has performed many fibula free flap procedures, said that rarely happens. “The patient may be worn out from going through that major reconstruction operation,” Mallen-St. Clair said. “And the oral surgeon could be worried about damaging the transplanted fibula while placing the implants.” Head and neck cancer patients often face additional challenges. If a cancer patient is treated with radiation after reconstruction, the new jawbone often is too weak to heal around dental implants. As a result, some cancer patients can have their disease treated and their jawbone reconstructed but will never have teeth again. A Team Approach For many patients, jaw-in-a-day offers an alternative. The Cedars-Sinai team first meets with biomedical engineers to preplan each patient’s procedure. The engineers use CT scans of the patient’s jaw and fibula and an intraoral scan of the patient’s teeth. The scans are used to create 3D-printed custom guides to help surgeons cut the bones and place the dental implants. A titanium plate is custom fabricated for each patient to help hold the transplanted bone in place. During the surgical procedure, which can last 10-15 hours, the surgeons use the custom guides to place dental implants in the fibula bone while it is still attached to the leg. They then remove the damaged jawbone, cut and move the section of fibula into place, and connect the blood vessels and nerves to the transplanted bone. “Thanks to this custom planning, everything fits like a glove,” said oral/maxillofacial surgeon Jay Lee, MD, DDS, who also works on the jaw-in-a-day team. “Everything is precise to the millimeter. The other thing that makes this procedure possible is our collaboration among doctors of different specialties working closely together for the good of our patients." Preplanning also reduces the time the bone being transplanted is left without blood supply, called ischemia time. “The longer the ischemia time, the greater chance the reconstruction will fail,” said Lee. “Without preplanning, it could take two to three hours to reshape the fibula bone to fit the jaw and shape a plate to hold it in place. During jaw-in-a-day, thanks to our cutting guides and prefitted plates, ischemia time is about 30 minutes.” Recovery and Results Following the procedure, the patient spends a few days in the intensive care unit, and a few more in the hospital. “The bone graft takes about three months to fully fuse into place,” Mallen-St. Clair said. “Once that is complete, the patient can receive the final prosthetic teeth, which should function like any other tooth in the mouth.” The Cedars-Sinai team has been doing about one jaw-in-a-day procedure a month, Lee said. Virtually anyone needing a jaw reconstruction is a candidate for the procedure, and while some surgeons focus mainly on replacing the jawbone, Mallen-St. Clair said dental implants are too important to overlook. “It's like night and day, the quality of life afterward,” Mallen-St. Clair said. “It's unbelievable how much difference the teeth make.” Read more on the Cedars-Sinai Blog: Creative Coping—Navigating Cancer During a Pandemic Related Stories RSS feed - Related Stories (opens in new window) View all headlines - Related Stories Cancer Patient Sails Again September 19, 2022 06:00 AM America/Los_Angeles Jeannea Jordan, who turns 80 in October, is a local sailing pioneer who began racing and cruising her 30-foot sailboat 25 years ago when few women were part of the sport. 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A terrible headache and … Read more Show previous items Show next items Contact the Media Team Email: [email protected] Share this release Rebuilding a Jaw in a Day Share on: Twitter Share on: Facebook Share on: LinkedIn Search Our Newsroom Social media Visit our Facebook page (opens in new window) Follow us on Twitter (opens in new window) Visit our Youtube profile (opens in new window) (opens in new window) Latest news 07 Oct 2022 - HealthDay: Black Women Less Likely to Get Laparoscopic Fibroid Surgeries 07 Oct 2022 - Faculty Publications: Sept. 29-Oct. 6 07 Oct 2022 - Fine-Tuning Organ-Chip Technology 06 Oct 2022 - KCRW: Want New Omicron Booster? Wait at Least 2 Months After Last Shot 05 Oct 2022 - Cedars-Sinai Schedules Free Flu Vaccine Clinics 04 Oct 2022 - Cedars-Sinai Showcases Hispanic and Latinx Art Newsroom Home