Jaw-In-a-Day Reconstruction: A Scoping Review of Clinical Outcomes and Evidence Gaps.

Abstract

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. 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. 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. 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.