A comparison of health-related quality of life using Jaw-in-a-Day surgery versus jaw reconstruction with primary endosteal implant placement and secondary prosthetic rehabilitation.

Abstract

There are no studies evaluating health-related quality of life (HRQOL) outcomes after Jaw-in-a-Day (JIAD) surgery. We used validated patient-reported outcome measures (PROMs) to compare HRQOL following JIAD and jaw reconstruction with primary dental implant placement and secondary prosthetic rehabilitation (non-JIAD). An exploratory, retrospective analysis of consecutive patients who underwent maxillomandibular reconstruction with primary endosteal dental implant placement with or without immediate dental rehabilitation was conducted from April 2022 to July 2025. HRQOL was assessed using the FACE-Q Head and Neck Cancer Module, MD Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI) from baseline to 24 months postoperatively. Multivariable generalized estimating equation regression models were used to compare longitudinal HRQOL. Eighty patients were included in the study (JIAD, n=25 and non-JIAD, n=55). Dental implant failure and early prosthesis removal rates in the JIAD cohort were 7% and 16%, respectively. HRQOL domains following JIAD demonstrated partial recovery at 6 months postoperatively; however, deficits (≥20 points) persisted at 24 months for the SHI, and 10/14 FACE-Q and 4/5 MDADI subscales. Multivariable analysis adjusted for age, sex, anatomical location of defect, and irradiation identified JIAD as a modest but statistically significant predictor of superior HRQOL for the SHI, and 8/14 FACE-Q and 2/5 MDADI subscales. Although JIAD was associated with greater HRQOL across several domains compared to primary dental implants with delayed dental prosthesis delivery, long-term deficits persisted across multiple subscales. Further prospective collection of HRQOL and functional outcomes is needed to inform the overall risk-benefit discussion of immediate dental rehabilitation.