When Cancer or Trauma Takes the Jaw, Rebuilding It Takes a Team.
Reconstructing a jaw after tumor resection is not a solo procedure. Dr. Jandali works alongside head & neck and reconstructive surgeons from the earliest virtual surgical planning session through the final implant-supported prosthesis — one coordinated plan, not a relay of separate appointments.
Dr. Jandali completed a Fellowship in Maxillofacial Prosthetics & Dental Oncology at Roswell Park Cancer Institute — specialized training focused specifically on rebuilding function and form after cancer treatment of the jaws and face.
Planned on the Computer Before It's Planned in the Operating Room.
Every reconstructive case begins with virtual surgical planning — a digital rehearsal of the entire operation before the first incision is made.
CT-Based Virtual Planning
The surgical team and Dr. Jandali review a 3D model built from the patient's CT scan, mapping the exact tumor margins and the bone that will need to be removed.
Reconstruction Is Designed Digitally
Depending on the defect, the plan calls for either a vascularized bone flap (often from the fibula, the non-weight-bearing bone of the lower leg) or a custom patient-specific plate. Cutting guides and hardware are designed to that exact plan.
Resection & Reconstruction
The head & neck / reconstructive surgical team removes the tumor and reconstructs the jaw the same day, using the custom hardware and, where planned, microvascular surgery to reconnect blood supply.
Implant-Supported Rehabilitation
Dr. Jandali restores function with implant-supported prosthetics. In select cases, implants and a provisional prosthesis are placed the same day as reconstruction; in others, implants are placed after the reconstructed bone has healed. The right timeline depends on the individual case.
A note on timing: Same-day implant and prosthesis placement at the time of jaw reconstruction — sometimes called a single-stage protocol — is possible for some patients when the anatomy and case allow it. It is not the plan for every case, and whether it's appropriate is determined jointly by the surgical and restorative team during virtual surgical planning, not decided in advance. This is a distinct process from the "same-day fixed teeth" protocol used on elective full-arch cases; oncologic and reconstructive timelines are individualized.
Three Reconstructions. Three Different Paths Back.
Images below are virtual surgical planning renderings — CT-based digital models used to design each reconstruction before surgery. No patient-identifying information is shown.
Ameloblastoma of the Mandible — Resection with Fibula Reconstruction and Full-Arch Implant Rehabilitation of Both Jaws
Ameloblastoma is a benign tumor — but a locally destructive one, capable of hollowing out and expanding the jawbone from the inside even though it does not spread elsewhere in the body. Left untreated, it continues to grow and weaken the bone. Management typically requires resection of the involved segment of the mandible.
In this case, the affected portion of the mandible was resected and reconstructed with a vascularized fibula free flap — bone microsurgically transferred from the lower leg to rebuild the jaw with its own blood supply intact. Because the patient's remaining maxilla (upper jaw) was also edentulous, treatment planning addressed both arches together: implants were placed in the reconstructed mandible and in the maxilla, restoring a full, implant-supported set of teeth rather than treating the reconstructed jaw in isolation.
The goal: full removal of a locally destructive tumor with jaw continuity, facial support, and chewing function restored through implant-supported teeth in both the reconstructed lower jaw and the opposing upper jaw.
Maxillary Malignancy — Resection with Custom Patient-Specific Implant Reconstruction
Malignant tumors of the maxilla (upper jaw) require resection with an adequate margin of healthy tissue around the tumor, coordinated with the head & neck surgical and oncology team. The maxilla is thinner and more complex in shape than the mandible, and it sits directly beneath the eye socket and nasal cavity — reconstruction has to restore both the structural support of the midface and a stable foundation for teeth.
In this case, reconstruction used a custom patient-specific implant — a titanium framework designed in virtual surgical planning to precisely match the resected anatomy — rather than a vascularized bone flap. The framework was fixed to the remaining facial skeleton and used to support an implant-retained dental prosthesis, restoring the dental arch in the same reconstructive plan.
The goal: complete tumor resection with midface support and dental function restored through a custom-engineered implant framework and prosthesis, planned as a single reconstructive sequence with the surgical team.
Reconstruction of a Prior Mandibular Resection for Malignancy — Fibula Free Flap with Implant-Supported Prosthetics
This case involved rebuilding a mandible previously resected for a malignant tumor. Reconstruction again used a fibula free flap — in this case, two shaped segments of the harvested fibula, positioned and fixed to recreate the contour of the missing jaw and re-connected to the blood supply in the neck under the microscope.
Dental implants were incorporated into the virtual surgical plan and placed within the transferred bone alongside the reconstruction, positioned to support a full-arch implant prosthesis opposing the natural or restored upper arch.
The goal: re-establishing jaw continuity and a stable, implant-supported bite following prior cancer surgery, coordinated between the reconstructive surgical team and Dr. Jandali's restorative planning.
One Plan. Not a Relay of Referrals.
Oncologic reconstruction goes wrong most often at the handoffs — when the surgical team and the restorative team aren't planning together from the start. That's the piece Dr. Jandali's training and referral relationships are built to close.
Fellowship-Trained for This Exact Discipline
Dr. Jandali completed a Fellowship in Maxillofacial Prosthetics & Dental Oncology at Roswell Park Cancer Institute — training built specifically around rebuilding function after cancer treatment of the jaws and face, not general restorative dentistry applied to an oncology case.
Involved From the Virtual Surgical Planning Session
Restorative planning happens alongside the surgical plan, not after the fact. Implant position, prosthetic space, and the eventual bite are considered while the resection and reconstruction are still being designed.
In-House Digital Lab
Implant-supported prosthetics for reconstructed jaws are designed and fabricated using the same in-house digital workflow Dr. Jandali uses for every implant case — no waiting on an outside lab during a time-sensitive reconstruction.
Situations Where This Kind of Care Applies
You've been diagnosed with a tumor of the jaw — benign or malignant — and your surgical team has discussed resection
You're scheduled for or have already had jaw reconstruction with a free flap or custom implant, and need a restorative plan
You've had prior jaw cancer surgery elsewhere and are missing teeth or a stable bite as a result
Your surgical team is looking for a restorative partner to join the virtual surgical planning process
You want a second opinion on a reconstructive or prosthetic plan already proposed elsewhere
You're missing teeth after radiation or other cancer treatment affecting the jaws
Frequently Asked
Your Surgical Team Has a Plan.
Let's Build the Restorative Side of It Together.
Whether you're newly diagnosed, already scheduled for reconstruction, or looking for a second opinion after treatment elsewhere, Dr. Jandali is glad to review your case and coordinate with your surgical team.
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