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Jaw-in-a-day (JIAD) para indicaciones malignas: una revisión sistemática

Jessica Trac¹, Rashi Ramchandani², Pallavi Dutta³

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.

|December 21, 2025

Resumen

Jaw-in-a-day (JIAD) ofrece resección, reconstrucción y rehabilitación dental exitosas para pacientes con cáncer de cabeza y cuello (CCC). Sin embargo, la radiación adyuvante aumenta el riesgo de falla de la prótesis asociada con osteorradionecrosis, lo que requiere una cuidadosa selección del paciente y discusión de riesgos y beneficios.

Área de la Ciencia:

Cirugía Oral y Maxilofacial
Oncología
Cirugía Reconstructiva

Sus antecedentes:

Jaw-in-a-day (JIAD) combina resección, reconstrucción maxilofacial y rehabilitación dental inmediata.
La evidencia de JIAD en poblaciones oncológicas, específicamente en cáncer de cabeza y cuello (CCC), es limitada.
Este estudio revisa sistemáticamente los resultados de JIAD en pacientes con CCC.

Objetivo del estudio:

Evaluar la eficacia y los resultados de los procedimientos Jaw-in-a-day (JIAD) en pacientes con cáncer de cabeza y cuello (CCC).
Evaluar la supervivencia de la prótesis, la oseointegración de los implantes y las complicaciones en pacientes con CCC sometidos a JIAD.

Principales métodos:

Se realizó una revisión sistemática siguiendo un protocolo predefinido (PROSPERO CRD420251043510).
Se realizaron búsquedas en MEDLINE, Embase, CENTRAL, Web of Science y CINAHL (enero de 2013 - octubre de 2025).
Se incluyeron estudios que involucran pacientes con CCC de todas las edades sometidos a JIAD; el riesgo de sesgo se evaluó utilizando MINORS.

Principales resultados:

Nueve estudios con 57 pacientes con CCC incluidos; los diagnósticos comunes fueron carcinoma de células escamosas de mandíbula.
Se utilizaron universalmente colgajos libres de peroné (100%). La supervivencia de la prótesis fue del 78,1 % (25/32), siendo la osteorradionecrosis (ORN) una razón común para la extracción (10,5 %).
La oseointegración temprana de los implantes fue del 100 % en sitios irradiados, pero se produjo una falla tardía de los implantes en el 11,1 % de los implantes dentro del campo de radioterapia.

Conclusiones:

Jaw-in-a-day (JIAD) puede lograr altas tasas de éxito en pacientes y defectos seleccionados con cáncer de cabeza y cuello (CCC).
Si bien la oseointegración temprana es favorable, la radioterapia adyuvante aumenta el riesgo de falla de la prótesis relacionada con ORN.
La consideración cuidadosa de los riesgos, beneficios y la estadificación del cáncer es crucial para la selección del paciente en JIAD para CCC.

Palabras clave:

Cáncer de cabeza y cuello JIAD Mandíbula en un día Mandíbula en un día Reconstrucción maxilofacial Oncología

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