SS46 - Executing the Prosthodontic Steps in the Jaw in a Day Approach: A Step-by-step Protocol for Delivering a Hybrid Prosthesis in the Operating Room
Attending Surgeon OMFS, Head Neck Microvascular Reconstructive Surgery Head and neck surgical associates Portland, Oregon
The combined prosthodontic and microvascular surgical nature of the Jaw in a Day technique creates an interesting paradigm; most microvascular surgeons are not well-versed in prosthodontic principles and feel they need a prosthodontist for the dental prosthesis conversion. Yet, many prosthodontists perceive the JIAD conversion step as being something vastly different than that of an immediate dental implant supported hybrid procedure. A technique will be described that simplifies this conversion process using extraoral registration techniques prior to the division of the tibioperoneal vasculature at the lower extremity. This is facilitated by a dental-modified “resected model” that mimics a dental articulator and facebow instrument. This approach has advantages compared to conversion within the oral cavity and previously described approaches in that it improves access and visibility, decreases blood and salivary contamination, makes use of a model that simulates a dental articular familiar to prosthodontists and potentially decreases ischemia time. This simplified approach allows the conversion process to be performed reliably by either a surgeon or prosthodontist.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Describe the specific implant components required to convert a hybrid prosthesis in the operating room for use in the Jaw in a Day technique.
Examine a simplified step-by-step protocol on how to execute the conversion of a lab or in house manufactured prosthesis onto implants placed into a fibula or scapula.
Demonstrate the Jaw in a Day technique with or without a prosthodontist in the operating room at the time of the procedure.