Single-Institution Analysis of Immediate and Delayed Jaw Reconstruction

Background: Traditional methods of mandibular reconstruction commonly utilize the fibula-free flap with delayed placement of dental prostheses. Recently, immediate prosthesis placement has been introduced to eliminate the period of edentulism. This study aimed to compare the surgical outcomes of patients undergoing immediate jaw reconstruction (IJR) with those undergoing traditional fibula-free flap mandibular reconstruction (FFFMR) at our institution. Methods: Following IRB approval, a retrospective review was conducted on patients who underwent either traditional FFFMR or IJR at our institution between 2015 and 2024. Patients were divided into either the traditional or the IJR cohort. Propensity score matching was used to control for confounding variables, and the surgical outcomes of the two cohorts were compared. Results: A total of 116 patients were included in the study, with 97 in the traditional group and 19 in the IJR group. Demographics and clinical factors were similar between the two groups, although patients in the traditional cohort were more likely to have malignant disease. Following propensity score matching, no significant differences in complication rates were observed between groups. The surgery duration was significantly shorter in the IJR group compared to the traditional FFFMR group in both the unmatched and matched analyses. Conclusion: IJR demonstrated comparable postoperative surgical outcomes to the traditional FFFMR approach. These findings suggest that IJR is not inferior, and support this method as a feasible, safe alternative to provide immediate functional and aesthetic benefits for appropriately selected patients.