Frequently Asked Questions

CRJ is an advanced surgical procedure that combines removal of jaw abnormality, reconstruction with a fibula free flap, immediate placement of dental implants, and a temporary prosthesis in a single operation. This approach restores both the function and aesthetics of your jaw, significantly reducing the overall treatment timeline.

Our team consists of three board-certified surgeons: Dr. Anastasiya Quimby, an Oral and Maxillofacial Surgeon fellowship-trained in Head and Neck Oncologic and Microvascular Reconstructive Surgery; Dr. James Azzi, an Ear, Nose, and Throat Surgeon fellowship-trained in Head and Neck Oncologic and Microvascular Reconstructive Surgery; and Dr. Jeronimo Guzman, an Oral and Maxillofacial Surgeon specializing in dental implants placements and well versed in the rehabilitation portion.

Our team uses virtual surgical planning (VSP) to create a precise and personalized surgical plan. VSP allows us to map out the resection, reconstruction, implant placement, and prosthesis design with unparalleled accuracy, minimizing risks and optimizing outcomes.

We incorporate Platelet-Rich Fibrin (PRF), a cutting-edge regenerative therapy, to promote faster healing, reduce infection risks, and enhance bone and soft tissue regeneration. This unique aspect of our approach improves recovery and reduces the likelihood of complications.

Candidates include patients needing jaw resection due to conditions such as cysts and tumors, trauma, osteoradionecrosis and osteonecrosis induced by certain medications to treat osteoporosis and/or Metastatic Bone Cancer. A thorough evaluation by our multidisciplinary team will determine your suitability for CRJ. For more information, please see Dr. Quimby's page covering CRJ on her website.

• Shortened treatment timeline
• Immediate restoration of function for speaking and chewing
• Enhanced cosmetic results
• Fewer surgeries and shorter overall recovery time

Potential risks include:

• Infection
• Flap failure
• Implant failure
• Anesthesia-related complications

Our use of PRF and VSP significantly reduces these risks by enhancing healing and ensuring surgical precision.

Recovery typically includes:

• A hospital stay of 7–10 days for monitoring and initial healing
• Rehabilitation with our experienced team of speech therapists, physical therapists, occupational therapists, and lymphedema specialists
• A gradual return to daily activities over 6–8 weeks
• Follow-up appointments to assess prosthesis fit and implant integration

Yes, after your initial recovery. You will be fed via a temporary feeding tube through your nose for the first 4–7 days after surgery, gradually re-starting oral intake under close supervision of our speech and swallow specialists. Once cleared for oral intake, you will start with a liquid diet for 1–2 weeks after surgery. As your implants and incisions heal and your prosthesis is adjusted, you will transition back to a normal diet over the course of 6–8 weeks.

This complex surgery typically takes 8–14 hours, including the resection, reconstruction, implant placement, and fitting of the temporary prosthesis.

The fibula is carefully harvested to preserve function. Some patients may experience temporary swelling, weakness, or changes in sensation, but these usually improve with time and physical therapy.

You will receive a temporary prosthesis immediately after surgery. Once healing is complete, our prosthodontist colleagues will create a permanent prosthesis for optimal function and aesthetics.

While CRJ is designed to be a single-stage reconstruction, minor revisions of the prosthesis or minor soft tissue modifications around the implants may be necessary during follow-up to ensure the best outcomes.

• Stop smoking to enhance healing and reduce complications
• Discuss medications, supplements, and medical history with your surgical team
• Arrange for support at home during recovery
• You will be given a personalized post-op instructions in regards to your diet and physical activity.

Temporary changes in speech may occur due to swelling or prosthesis adjustments. Speech therapy will help improve communication as you recover.

The fibula free flap allows for precise reconstruction of the jaw’s contour. Coupled with VSP and PRF, this approach ensures natural aesthetics while promoting optimal healing.

Long-term success is high (>95%) when patients follow post-operative care instructions and maintain regular follow-ups. Our integration of regenerative medicine, such as PRF, further enhances outcomes by reducing complications and improving healing.

Frequent follow-ups will be necessary initially to monitor healing and adjust your prosthesis. Regular long-term check-ups will ensure your implants remain stable and functional.

Pain management is a priority. You will receive medications to control discomfort, and the use of PRF reduces inflammation and promotes a more comfortable recovery.

Scars will be present at the donor site (leg) and on the reconstructed jaw. Advanced surgical techniques are used to minimize scarring and improve cosmetic outcomes.