Jaw surgery for cancer patients and others can sometimes take several years to be completed, with the patient undergoing multiple procedures to place a prosthetic, secure and attach dental implants and undergo treatment for their disease.
At Roswell Park Comprehensive Cancer Center, the entire process can be completed within a single day.
With the One Day Jaw Reconstruction procedure, a multidisciplinary team of surgeons led by Vladimir Frias, DDS, MD, FACP, Director of Maxillofacial Prosthetics, and Michael Markiewicz, MD, DDS, MPH, FACS, FACD(c), a Head & Neck/Plastic & Reconstructive Surgeon, are able to remove the tumor, place the bone implant, typically a piece of the patient’s fibula, along with the dental prosthetics, all at the same time. The process takes eight to 12 hours, but it allows the patient to go home within a few days without losing any vital parts of their teeth or jaw.
The procedure relies heavily on practices being pioneered at Roswell Park, with the team first doing a virtual scan and 3D planning to map out the surgery from tumor removal to reconstruction and implantation. The team conducts the procedure virtually from start to finish, working out checks and balances to make sure everything will work smoothly on the day of the procedure. The patient returns for a preoperative visit for final details, then comes in for the procedure.
Dental resin is used on a 3D printed prosthetic, assembled in a lab and ready for implantation ahead of time, allowing them to deliver a sterile prosthetic in a sterile field without concerns for contamination.
For patients who need to have radiation, their healing is delayed a little, but within three months after their radiation treatments are completed, surgeons can remove the temporary prosthetic, make new jaw impressions and replace it with a permanent zirconium prosthetic the patient can use immediately.
Dr. Frias, who also creates prostheses for other parts of the body to help patients with head and neck cancers feel more like themselves after treatment, has been recognized with the Barron Award, given by the American Academy of Maxillofacial Prosthetics for excellence in the field.
So far, the team has completed 20 Jaw in a Day procedures with the intent to continue refining the process to make it even more accurate and efficient.