Immediate dental implants in jaw reconstructions show high accuracy with mean deviations under 2mm: A cohort study

The "Jaw in a Day®" approach enables simultaneous functional and aesthetic mandibular reconstruction through immediate dental implant placement in osseous free flaps. This retrospective cohort study evaluated the accuracy of immediate dental implant placement during mandibular reconstruction with fibula free flap by measuring deviations between virtual surgical plans and actual implant positions. Ten patients who underwent fibula free flap reconstruction with immediate dental implant placement using virtual surgical planning were analyzed from a single center between April 2023 and January 2024. Thirty-two dental implants were assessed were assessed in 10 patients (mean age 59.0 ± 15.3 years, 70 % male). Mean coronal deviation was 1.99 ± 0.91 mm, apical deviation was 1.64 ± 0.87 mm, and angular deviation was 3.98 ± 0.96°. Clinical factors including fibula segment length, number of bone segments, Brown classification, surgical approach, and tumor type did not significantly influence implant accuracy (all p > 0.05). Mixed-effects linear models revealed high intraclass correlation for linear deviations (ICC 55-58 %) but not angular deviation (ICC 0.2 %). Virtual surgical planning combined with the Jaw in a Day® procedure demonstrates reliable implant accuracy for single-stage mandibular reconstruction. The provisional "floating prosthesis" compensates for surgical errors and guides precise implant positioning, supporting the clinical viability of immediate dental rehabilitation in mandibular reconstruction.