One-stage prosthodontically driven jaw reconstruction in patients with benign and malignant pathologies: A 7- to 11-year cohort study.

OBJECTIVES: One stage functional jaw reconstruction is defined as the resection and reconstruction of segmental defects in conjunction with the placement of dental implants in an ideal prosthetic position and loaded with a provisional restoration, during one surgical procedure. The aim of the study is to describe clinical outcomes of patients who underwent one stage functional jaw reconstruction. METHODS: Patients who underwent one-stage functional jaw reconstruction, from January 2013 to March 2016 were recalled in 2022 and 2023. Planning and execution for the reconstruction utilized either analogue or digital techniques. Outcome parameters recorded were treatment-related outcomes at patient level, implant-related outcomes and patient-reported outcome measures. RESULTS: Eighteen patients underwent one-stage jaw reconstruction with a total of 57 implants. Four patients had maxillary and 14 had mandibular reconstructions. Ten patients underwent postoperative radiotherapy. Ten patients were planned using analogue and eight by digital planning. Three patients had partial flap necrosis, three patients had plate fractures, implant loss was seen in one patient and four patients died during the period. A functional prosthesis was provided in 16 out of the 18 patients. CONCLUSION: One-stage functional jaw reconstruction is a predictable method for providing rehabilitation with successful outcomes at 7-11 years. However, caution should be exercised when the treatment modality is carried out in patients with malignant pathologies who have undergone radiotherapy.

Comparison of limb reconstruction with vascularized fibula flap versus induced membrane technique in 54 pediatric cases over 16 years.

BACKGROUND: Children's bone loss of limbs represents a significant challenge for surgeons, especially given that children are growing individuals. In the pediatric population, we compared bone reconstruction using vascularized fibula flaps with the induced membrane technique. The primary purpose of this study was to evaluate the delay and quality of consolidation. METHODS: Data from patients who underwent limb reconstruction using either the fibula flap or the induced membrane were retrospectively collected from files across two centers. Perioperative and long-term complications were documented, along with functional and aesthetic outcome. RESULTS: Between 2004 and 2020, 31 children underwent limb reconstruction using a fibula flap, and 13 patients were treated using the induced membrane technique. The etiologies included 76% tumors, 20% congenital pseudarthroses, and 3.7% infections. The median size of the bone resection was 12.5 cm (range: 1.8 to 31 cm). The median time to consolidation after free fibula flap transfer was 10 months (range: 2 to 55 months) versus 7.5 months (range: 1 to 64 months) for the Masquelet technique (p = 0.54). Limb length inequality occurred in 52% of fibula cases and 39% of the induced membrane cases (p = 0.55). CONCLUSIONS: Both of free fibula flap and the induced membrane technique are effective options for bone reconstructing long bones in children. These techniques yield good functional outcomes and have comparable consolidation times.

Unveiling the Extraordinary: A Rare Type IIIA Infra-Popliteal Arterial Variation in a Free Fibula Osteocutaneous Flap for Mandibular Reconstruction.

The free fibula flap (FFF), based on the peroneal artery (PA) system, is the gold standard for mandibular reconstruction. Various anatomical variations in the infra-popliteal lower limb vascular system exist. These variations present as an intraoperative surprise to surgeons even after an unremarkable clinical vascular examination of the leg. Here, we report one such case, where we performed successful mandibular reconstruction after encountering a Type IIIA variation of infra-popliteal arterial vasculature.

Single-Stage Reconstruction with Innate Chimeric-Free Fibula Flap in Limb-Preserving Excision of Upper Limb Sarcomas.

Introduction: The limb-preserving excision is the standard of care in upper limb sarcoma management, but the resulting complex composite defects are exacting the expertise of the reconstructive surgeons. This study was done to evaluate a novel single-stage reconstruction of these defects using an innate chimeric-free fibula flap (a nonfabricated, anatomically available multiple tissue components harvested on independent perforators arising from the same peroneal source vessel). Patients and Methods: Twenty patients (16 male/4 female) with an average age of 29.5 years with upper extremity sarcoma (Enneking IIA/IIB) were treated by wide local excision and innate chimeric-free fibula flap reconstruction from March 2012 to March 2020. All the patients were followed for an average period of 18.3 months. At the end of the follow-up, the outcome was assessed by musculoskeletal tumor score (MSTS). Results: The flow-through flap was done in five patients. Muscle-tendon unit defects were reconstructed with a vascularized peroneus longus muscle-tendon unit in 15 patients. Nerve gap reconstruction using vascularized superficial peroneal nerve was done in eight patients. All patients had a segmental defect in the appendicular skeleton that was reconstructed with the vascularized fibular strut component. Soleus chimeric muscle component was used as a void filler and for covering the hardware in seven patients. The average size of the chimeric cutaneous component paddle was 30.7 cm2. The average length of fibula used for reconstruction was 16.6 cm. All flaps survived well, facilitating good hand function at the end of the follow-up. The average outcome score as per the MSTS was 22 (p = 0.035). Conclusion: The innate chimeric-free fibula flap provides all tissue components facilitating a good functional outcome. The advantage is the restoration of a functional hand in a single-stage reconstruction.

Donor Site Morbidity in Patients Undergoing Maxillofacial Reconstruction Using Free Fibula Flap Versus Deep Circumflex Artery Flap-A Systematic Review.

Introduction: A systematic review of the literature on the donor site morbidity in patients undergoing Maxillofacial reconstruction was performed. The two widely used flaps namely free fibula flap (FFF) and DCIA flap were compared to answer the following questions: (1) Is donor site morbidity significantly different in patients undergoing maxillofacial reconstruction with FFF and DCIA flap? (2) Should donor site morbidity be considered as the criteria for choosing the flap for reconstruction. Materials and methods: The search strategy was based on PRISMA guidelines. Various electronic databases were searched. On reviewing the seven articles included in our systematic review, we found out oral squamous cell carcinoma to be the most common pathology leading to the defects in head and neck region requiring reconstruction with free flaps. Results: A total of 531 participants were investigated who underwent maxillofacial reconstruction using FFF and DCIA flap. The study included both the genders. The participants were assessed for short- and long-term donor site morbidity after the microvascular surgery. Mean age is 45-60 years. Three out of seven studies showed DCIA to have lesser complications at donor site than fibula group. While other two studies proved FFF to be better than DCIA. One study proved low donor site morbidity with regard to both the flap. Conclusion: The free fibula being the flap of choice in head and neck reconstruction has a comparable donor site morbidity to DCIA. The advantages of the iliac artery flap include natural curvature, abundant vertical and horizontal bone height for bone contouring and osseointegration, hidden scar, low incidence of wound healing problems and minimal effect on function and quality of life at long-term follow-up. Thus, it makes it the free flap of choice that one cannot avoid. This systematic review was registered at PROSPERO (CRD42021268949).

Diagnostic and Prognostic Value of Indicators of Bone Metabolism Markers in Patients Following Mandibulectomy and Free Fibula Flap Reconstruction with Endosteal Implants.

Purpose: To evaluate and assess the indicators of bone metabolism markers osteocalcin and ß-Cross-Laps in blood serum as a tool for monitoring bone regeneration and determining the time of implantation in patients after mandibulectomy and reconstruction of a free fibular flap with subsequent endosteal implants. Materials and Methods: Forty-eight patients in a 6-year period participated in this study, due to resection for tumors. All patients underwent reconstruction with fibula free flap after tumor resection, 4-6 months after osteoectomy, dental implants were installed with further orthopedic rehabilitation. To assess the rate of bone remodeling after transplantation, the content biochemical markers of bone remodeling osteocalcin and ß-Cross-Laps serum were determined by enzyme immunoassay. Results: All 46 fibular free flaps were healed without complications and were survived. A total 326 implants installed, 8 implants failed to osseointegrate, and 6 implants failed after 5 years of loading (peri-implantitis). Success rate of implants after 5 years was 95,7%. In patients before surgery, the mean of osteocalcin levels was 8.5 ng/ml, two months later, there was a sharp increase in the content of osteocalcin by 15.4 ng/ml, after four months reached 24.7 ng/ml, after six months of 28.6 ng/ml, then the indicator began to decrease and after 12 months it was approaching the norm of 14.7 ng/ml. In patients before surgery, the mean level of ß-Cross-Laps was 0.76 ng/ml, after two months bone transplantation the mean level of ß-Cross-Laps decreased to - 0.65 ng/ml, after four months the indicator increased and reached of 0.98 ng/ml, after six months the indicator was - 1.56 ng/ml, then these indicators began to decrease and after 12 months, approaching normal values of - 0.87 ng/ml. There is a correlation between different concentrations of osteocalcin or ß-Cross- Laps and the success rate of implants. Implants were shown to be unsuccessful low concentrations of osteocalcin and high concentrations of ß-Cross-Laps in serum. Conclusion: Studies have shown that the long-term survival and success rates of implants placed in the reconstructed areas may guarantee an excellent prognosis of implant-supported prostheses. Bone markers in blood serum osteocalcin and ß-Cross-Laps can be used to evaluate the rate of bone remodeling, which allows you to determine the time of implantation.

Reconstruction of Segmental Mandibular Defects with Double-Barrel Fibula Flap and Osseo-Integrated Implants: A Systematic Review.

Background: Mandibular defects resulting from oncological treatment pose significant aesthetic and functional challenges due to the involvement of bone and soft tissues. Immediate reconstruction is crucial to address complications such as malocclusion, mandibular deviation, temporomandibular joint (TMJ) changes, and soft tissue retraction. These issues can lead to functional impairments, including difficulties in chewing, swallowing, and speech. The fibula flap is widely used for mandibular reconstruction due to its long bone segment and robust vascular supply, though it may not always provide adequate bone height for optimal dental rehabilitation. This systematic review aims to determine if the double-barreled fibula flap (DBFF) configuration is a viable alternative for mandibular reconstruction and to evaluate the outcomes of dental implants placed in this type of flap. Materials and Methods: This study adhered to the Cochrane Collaboration criteria and PRISMA guidelines and was registered on the International Platform of Registered Systematic Review and Meta-Analysis Protocols Database (INPLASY2023120026). We included clinical studies published in English, Spanish, or French that focused on adult patients undergoing segmental mandibulectomy followed by DBFF reconstruction and dental rehabilitation. Data sources included Medline/PubMed, the Cochrane Library, EMBASE, Scopus, and manual searches. Two reviewers independently screened and selected studies, with discrepancies resolved by a third reviewer. Data extraction captured variables such as publication year, patient demographics, number of implants, follow-up duration, flap survival, implant failure, and aesthetic outcomes. The risk of bias was assessed using the JBI appraisal tool, and the certainty of evidence was evaluated using the GRADE approach. Results: A total of 17 clinical studies were included, evaluating 245 patients and 402 dental implants. The average patient age was 43.7 years, with a mean follow-up period of 34.3 months. Flap survival was high, with a 98.3% success rate and only four flap losses. The implant failure rate was low at 1.74%. Esthetic outcomes were varied, with only three studies using standardized protocols for evaluation. The overall certainty of evidence for flap survival was moderate, low for implant failure, and very low for aesthetics due to the subjective nature of assessments and variability in reporting. Conclusions: The primary limitations of the evidence included in this review are the observational design of the studies, leading to an inherent risk of bias, inconsistency in reporting methods, and imprecision in outcome measures. Additionally, the subjective nature of aesthetic evaluations and the variability in assessment tools further limit the reliability of the findings. The DBFF technique demonstrates excellent outcomes for mandibular reconstruction, with high flap survival and low implant failure rates, making it a viable option for dental rehabilitation. However, the evidence for aesthetic outcomes is less certain, highlighting the need for more rigorous and standardized research. This review supports the DBFF as a good alternative for mandibular reconstruction with successful dental implant integration, although further studies are needed to enhance the reliability of aesthetic evaluations.

Salvage of Intraoral Dehiscence With a Superficial Temporal Artery Islandized Flap (STAIF).

Intraoral dehiscence compromises free fibula flaps following mandibular reconstruction. Salivary contamination risks thrombosis of microvascular anastomosis and hardware infection. The superficial temporal artery islandized flap (STAIF) provides a non-microsurgical reconstructive option for regaining intraoral competency for a time-sensitive complication. The STAIF is based on the superficial temporal artery coursing along the anterior hairline. The flap is mapped with the assistance of the Doppler probe. The width of the skin paddle is dependent upon the ability to close the donor site. The flap is taken down to the level of the zygomatic arch and tunneled into the mouth. We present a case of a patient who underwent mandibular reconstruction with a free fibula flap after a traumatic shotgun wound. The patient developed repeated intraoral dehiscence following failed local buccal and floor of mouth flaps leading to salivary contamination of the flap and hardware. The intraoral dehiscence was successfully salvaged on the third attempt with a STAIF. Intraoral dehiscence requires urgent attention to prevent loss of the free fibula flap after mandibular reconstruction. The STAIF is a non-microsurgical option for restoring intraoral competency. This robust, axially vascularized skin paddle may be split for intra- and extraoral coverage, as was performed in this case, and is an essential tool in the reconstructive armamentarium.

Identification of peroneal artery perforators using non-contrast-enhanced T2prep multi-shot gradient echo planar imaging MRA.

The purpose of this study was to investigate the spatial resolution of non-contrast-enhanced (CE) T2prep multi-shot gradient echo planar imaging (MSG-EPI) magnetic resonance angiography (MRA) required to identify peroneal artery perforators and demonstrate its effectiveness in preoperative simulation. Twenty-six legs of 13 volunteers were scanned using non-CE T2prep MSG-EPI-MRA at three spatial resolutions: 1.0-, 0.8-, and 0.6-mm isotropic voxels. The location and number of peroneal artery perforators that could be candidates for free fibula flaps were identified by consensus among three plastic surgeons. Surgeons distinguished between septocutaneous and musculocutaneous perforators using MRA, and confirmed the accuracy of their presence and identification using ultrasonography (US). The ability to detect hypoplasia or stenosis of the anterior tibial, posterior tibial, and peroneal arteries was evaluated by confirming the consistency between the MRA and US results. The number of cutaneous perforators identified using MRA and confirmed using US was 39, 51, and 52 at each respective resolution. The discrimination accuracies between septocutaneous and musculocutaneous perforators were 92.3%, 96.1%, and 96.2%. The number of identified septocutaneous perforators was 1.3 ± 0.6, 1.6 ± 0.8, and 1.7 ± 0.8 at 1.0-, 0.8-, and 0.6-mm data, respectively. All the MRA results, including hypoplasia and stenosis, were consistent with the US results. Non-CE T2prep MSG-EPI-MRA with a spatial resolution of 0.8 mm or less shows promise for identifying septocutaneous perforators of the peroneal artery, suggesting its potential as an alternative to conventional imaging methods for the preoperative planning of free fibula osteocutaneous flap transfers.

Results of a Novel Technique for Increasing Bone Contact and Stability in Mandibular Reconstruction with Micro-vascularized Fibula Flap.

Background: Reconstruction of large mandibular defects requires reestablishment of mandibular continuity with bone and soft tissue. The microvascularized fibula flap (MFF) has the advantage of providing both, with adequate length, low resorption rate, low infection risk and possibility of dental implant insertion. It can be adapted to mandibular defects in many different ways. Purpose: This retrospective study will present and evaluate the results of the male-female joint technique for flap positioning and fixation. Methods: The technique consists of designing osteotomies on the binding edge of the MFF and recipient jaw, increasing bone contact from one to five faces. Patients submitted to mandibular reconstruction through this technique were included and evaluated regarding systemic compromise, complication occurrence as well as primary and long-term stability. Results: Ten patients underwent mandibular reconstruction with the male-female joint technique. Sixteen joints were applied, and excluding an early loss due to vascular failure, all remaining 14 joints healed uneventfully. None showed signs of early or late mobility. Conclusion: Fitting the MFF through a male-female joint that provides greater bone contact may improve stability and reduce screw loosening and mini-plate removal rates.

Oral rehabilitation and associated quality of life following mandibular reconstruction with free fibula flap: a cross-sectional study.

Introduction: Mandibular reconstruction with the free fibula flap (FFF) has become a standardized procedure. The situation is different with oral rehabilitation, so the purpose of this study was to investigate the frequency of implant placement and prosthetic restoration. Additionally, the patients' situation, motivation, and treatment course were structurally assessed. Materials and methods: All cases between January 2013 and December 2018 that underwent mandibular reconstruction in our department with a free fibula flap and gave written informed consent to participate were interviewed with two structured questionnaires about their restoration and quality of life. Additionally, medical records, general information, status of implants and therapy, and metric analyses of the inserted implants were performed. Results: In total 59 patients were enrolled and analyzed in this monocentric study. Overall, oral rehabilitation was achieved in 23.7% at the time of investigation. In detail, implants were inserted in 37.3% of patients and showed an 83.3% survival of dental implants. Of these implanted patients, dental implants were successfully restored with a prosthetic restoration in 63.6. Within this subgroup, satisfaction with the postoperative aesthetic and functional result was 79.9% and with the oral rehabilitation process was 68.2%. Satisfaction with the implant-borne prosthesis was 87.5%, with non-oral-squamous-cell-carcinoma patients being statistically significantly more content with the handling (p=0.046) and care (p=0.031) of the prosthesis. Discussion: Despite the well-reconstructed bony structures, there is a need to increase the effort of achieving oral rehabilitation, especially looking at the patient's persistent motivation for the procedure.

Triple Barrel Free Fibula Flap for Sternal Stabilization: A Case Report.

Sternal non-union is a rare complication of median sternotomies following cardiac surgery. It results in sternal instability and is associated with a high rate of morbidity. Patients with sternal non-union usually complain of pain and sternal clicking with movement of the chest wall. Diagnosis is confirmed on computed tomography showing a gap between two sternal halves. Surgical correction of sternal instability is challenging. The key objective is to reconstruct a thoracic cage that allows for biomimesis and preserves normal physiologic cardiac and pulmonary functions all whilst achieving an aesthetically pleasing result. In this article, we describe a novel technique for sternal instability reconstruction using a triple-barrel vascularized free fibula flap fixed with rib titanium plates. This approach provides rigid long-lasting stability while preserving chest wall biomechanics.

La désunion sternale est une complication rare des sternotomies pour chirurgie cardiaque. Il en résulte une instabilité sternale responsable d'une morbidité élevée comme la douleur et le cliquetis lors des mouvements thoraciques. Le scanner confirme le diagnostic en montrant la solution de continuité entre les 2 moitiés du sternum. La reconstruction chirurgicale est complexe. Son but est de reconstruire une cage thoracique solide, permettant des fonctions cardiaque et respiratoire normales tout en assurant une esthétique satisfaisante. Nous décrivons ici une nouvelle technique de reconstruction sternale par lambeau libre fibulaire tripartitionné fixé par des plaques costales en titane. Elle permet une stabilisation pérenne de la cage thoracique et la restauration de sa mécanique.

Virtual Surgical Planning in Condyle Reconstruction of Posterior Mandibulectomy Defects.

Background: Ameloblastoma is a rare odontogenic tumor most commonly located within the mandible. These tumors can grow to massive proportions and result in malocclusion. Segmental mandibulectomy and reconstruction with an osteocutaneous free flap are frequently required. Virtual surgical planning (VSP) aids the surgeon in creating precise anatomic reconstruction when there is preoperative malocclusion due to tumor size. In this study we seek to further examine reconstruction of posterior mandibulectomy defects inclusive of condylar resection. Methods: Retrospective review of patients treated for giant ameloblastoma (tumor >4 cm) was examined; 3 patients with posterior tumors requiring ramus and condylar resection were included. Reconstruction in all patients was performed using fibula free flaps and VSP custom-made mandibular reconstruction plates. In these patients the reconstructed ramus was shortened and precise contouring done with a burr to recreate the native condylar surface. Intermaxillary fixation was used to maintain occlusion for 1 month postoperatively. Inferior alveolar nerve repair with allograft and nerve connectors was performed for all 3 patients. Results: All patients underwent successful mandibular reconstruction with preservation of mandibular function and improved occlusion postoperatively. Inferior alveolar nerve repair using nerve allograft allowed for neurosensory recovery in the mandibular division of trigeminal nerve distribution in 2 of the 3 patients. Conclusions: Giant ameloblastoma involving the mandibular condyle can be successfully treated with the fibula free flap utilizing mandible reconstruction plates and VSP. This technique allows for excellent restoration of occlusion and neurosensory recovery when paired with reconstruction of the inferior alveolar nerve at time of reconstruction.

Heterotopic Ossification After Reconstruction with Free Fibula Flap - an Ambiguous Mishap.

Heterotopic ossifications (HO) are rare, yet, well reported complications after free flap transfer. We present a case of HO that occurred within a month, and has not been previously described in the literature. This serves as a reminder that bony hard swellings proximal to the free flap within a month should raise the suspicion of HO.

Soft-tissue, non-osteogenic distraction of the mandible and lower face in bilateral hemifacial microsomia-technical report.

The aim of this study is to present a sequential strategy of soft-tissue, non-osteogenic distraction with a novel device, followed by microvascular bony reconstruction for severe cases of mandibular hypoplasia. The case of a 21-year-old woman with Goldenhar syndrome is presented, whose mandible remained severely hypoplastic despite previous attempts at distraction and was not suitable for further osteogenic distraction. Soft tissue deficiency and pin track scarring prevented free fibular transfers. A personalized distractor, anchored to the cranium and the mandibular symphysis, was designed to expand the soft tissues while allowing for physiological temporomandibular joint (TMJ) movement without compression forces. Internal distractors were placed along the osteotomies to prevent condylar luxation. After completion of the soft tissue distraction, the native mandible was resected except for the condyles and reconstructed with two free fibula flaps. This report represents the proof of concept of a sequential approach to severe lower face soft-tissue and bone deficiency, which preserves TMJ function and avoids the transfer of poorly matched skin to the face.

Quality of life and subjective donor-site morbidity in patients after a free fibula flap.

INTRODUCTION: We evaluated the subjective donor-site morbidity and quality of life in patients with a free fibula flap (FFF) reconstruction in terms of self-reported symptoms, function and quality of life, and we compared inclusion vs. exclusion of the flexor hallucis longus (FHL) muscle in the graft, primary wound closure vs. skin graft and the occurrence vs. absence of donor-site complications. METHODS: In this cross-sectional study, patients who underwent a mandibula or maxilla reconstruction with a FFF between 2011 and 2021, were included. Symptoms and function were measured with the Foot and Ankle Outcome Score (FAOS) and quality of life with both FAOS and a Visual Analogue Scale (VAS). RESULTS: Thirty-four patients were included in the analyses (mean age 59 years, 59% males). Most patients underwent a mandibular reconstruction for a malignancy. The median FAOS domain scores ranged between 92.9 (interquartile range (IQR) 77.7-100.0) and 100.0 (IQR 88.2-100.0) points, and the median VAS score was 86.5 points. No statistically significant differences were found between inclusion vs. exclusion of the FHL, primary wound closure vs. graft and occurrence vs. absence of donor-site complications. An unfavorable trend was seen for inclusion of the FHL in the flap on recreational functioning, and quality of life. CONCLUSION: Patients who underwent a FFF experience little donor-site morbidity and high quality of life, as measured by FAOS and VAS.

Autogenous, alloplastic, or hybrid for total mandibular reconstruction; is here an optimal path?

For less fit patients, total reconstruction of the mandible (TRM) is an elucidated alternative for severe maxillofacial defects. This study aimed to comprehensively review and analyze the existing evidence, irrespective of the underlying pathologies, to provide a consolidated overview of the current state of TRM. An electronic search was performed on PubMed, Embase, Scopus, and Google Scholar to identify studies reporting TRM without restrictions on patient age, type of pathology underlying the mandibular defect, and study type. Electronic search identified 390 studies; only 21 met the inclusion criteria, documenting 7 (33.3%) autogenous, 6 (28.6%) alloplastic, and 8 (38.1%) hybrid TRMs. All studies reported one clinical case, except for two studies that reported two patients treated with TRM. The mean age of the patients was 39.0 ± 19.4 years, and the mean follow-up was 22.3 ± 14.7 months. Osteomyelitis was the most common pathology. Bilateral condyles were preserved in only two cases. The TRM has been reported in clinical cases only and no large cohort study is available. Functional and aesthetic parameters have either not been reported or have been reported in heterogeneous formats, thus hampering comparisons of autogenous, alloplastic, and hybrid TRMs. Overall, TRM in patients presenting with severe maxillofacial defects achieved promising clinical outcomes endowed with acceptable function and aesthetics. Large cohort studies are needed to validate these results.

Free flap jaw reconstruction with dental implantation: A single-institution experience.

BACKGROUND: We sought to review our institution's experience with dental implant placement in free flap jaw reconstruction to determine factors impacting restoration of dental occlusion. METHODS: Exactly 48 patients underwent free flap jaw reconstruction with or without dental restoration from 2017 to 2022. Primary outcome was achievement of restored dental occlusion after jaw free flap reconstruction. RESULTS: A total of 48 patients with a mean age of 59.8 ± 16.4 years underwent jaw reconstruction from 2017 to 2022. Ten patients (20.8%) received osteointegrated dental implants. Two patients received a temporary dental prosthesis, 12 ± 4 months after initial reconstruction. Three patients received a final prosthesis, with a mean time to final prosthesis of 17.7 ± 12.4 months. Five patients did not receive any prosthesis despite placement of implants. CONCLUSION: A minority of patients received dental implant placement with free flap jaw reconstruction and only a small subset of these received a definitive dental prosthesis.