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Jaw-In-a-Day Reconstruction: A Scoping Review of Clinical Outcomes and Evidence Gaps
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DOI：10.1002/micr.70200.png)
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Abstract
En 中文
Background: Jaw-in-a-Day (JIAD) reconstruction-combining osseous free tissue transfer, dental implant placement, and intraoperative prosthesis delivery-provides immediate functional and psychosocial rehabilitation after segmental jaw resection. Despite increasing adoption, the existing evidence remains heterogeneous and inconsistently reported. Methods: A scoping review was conducted following PRISMA-ScR guidelines. PubMed/MEDLINE was searched through April 2025 for studies reporting true JIAD cases, defined strictly as simultaneous free-flap reconstruction, implant placement, and intraoperative delivery of a functional prosthesis. Data were extracted on study design, indications, reconstructive methods, prosthetic variables, implant and flap outcomes, soft-tissue findings, functional recovery, and complications. Results: Thirty-two studies (2009-2025) met inclusion criteria, describing 274 JIAD patients. Most reports were single-center case reports or series (77% Level IV-V evidence) and originated from the United States, with publication frequency increasing sharply after 2021. Reconstruction involved the mandible in 82% of cases, predominantly using fibula flaps (> 95%). Immediate prostheses were fixed in 95% and nearly always provisional, with definitive prosthesis typically delivered 3-6 months postoperatively. Implant survival ranged 87.5%-100% across short- to mid-term follow-up intervals. Maxillary reconstructions and intraoral skin paddles were each associated with increased implant complications in isolated cohorts, but these findings were not replicated. A dedicated series reported peri-implant reactive tissues in 21% of implants, managed with local soft-tissue procedures. Flap survival remained high (92%-100%), and functional recovery was typically rapid, although no study employed validated patient-reported outcome measures. One comparative cohort suggested lower osteoradionecrosis rates when implants were placed before adjuvant radiation, though sample size was small. Conclusions: JIAD reconstruction yields high implant and flap survival with encouraging early functional outcomes. However, the evidence base is limited by small samples, short follow-up, and inconsistent reporting. Standardized definitions, validated outcome measures, and multicenter prospective studies are needed to clarify long-term durability and refine patient selection.
Keywords:
head and neck surgery
immediate dental rehabilitation
immediate prosthesis
Jaw-in-a-Day
microvascular reconstruction
osseous free flap
virtual surgical planning
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