Jaw reconstruction

With many successful procedures behind him, Luke excels in the extremely complex and specialised field of jaw reconstruction.

Jaw reconstruction may be needed in the following cases:

• Cyst/tumour excision
• Facial trauma/damage
• Serious infection
• Age-related bone loss, lower jaw resorption

These conditions may require multiple procedures over a significant period to be effectively treated.

A specific set of reconstructive techniques are used to treat advanced bone loss of the upper and lower jaw. This condition affects the face in several ways, including: the retraction of the lower lip; thinning of the lips, greater and deeper wrinkling around the mouth and a saggy chin. The objective of treatment is to create a solid base for tooth replacement through implant placement combined with extensive bone grafting.

The bone grafting is designed to restore bone volume, and dental implant placement is required to correctly align the teeth and rebuild the soft tissues.

Bone replacement using custom designed implants

Lost tissue can successfully be replaced using implants for bone replacement surgery. Typically, metal implants are used for temporomandibular joint (TMJ) replacement and porous plastic implants for jawline contouring or repairing volume loss.

Free flap surgery

Free flap surgery is a micro-surgical technique that facilitates the repair of major trauma sites in the jaw. A piece of tissue (or flap) is detached from its original blood supply and moved from one part of the body to correct a defect in the jaw when reconnected to a new blood supply. The blood vessels feeding the flap are normally extremely small and the flap is reattached using microvascular surgery.

A good example of this is a fibular free flap, a process in which a small and non-essential bone is taken from your leg along with the attached blood vessels and transferred to your upper or lower jaw to fill a bony hole. This treatment is often implemented following treatment for cancer of the jaw.

What are the advantages of jaw reconstruction?

The primary benefit of jaw reconstruction is that the bone grafting will enable you to have dental inserts inserted in your mouth. In cases where a patient no longer has their teeth, they will be able to replace their normal dentures with implant-supported ones, offering greater stability, so they can talk and eat with confidence without fear of slipping.

How will I recover from jaw reconstruction?

Jaw reconstruction is a complex form of surgery, so some initial pain in the early days after bone grafting is to be expected, but because there are no nerves in the jaw, this won’t be significant pain, more a feeling of post-operative soreness. This soreness will however be accompanied by some swelling, so you should try not to smile or stretch the swollen tissue, because this may put unnecessary pressure on your surgical stitching. You may have a pink periodontal dressing applied. This dressing contains antibiotic and will protect the area from infection and also when the particulate bone used to rebuild your jaw is washed out.

Once the bone graft has successfully bedded in, it will start growing new, healthy bone, which will take a few months. If it has been possible to combine bone grafting with implant placement simultaneously, then it will take several months before the next steps in reconstructing your jaw can be taken. Normally, however, implants will be placed once your jaw has grown enough new bone mass to properly support them.