{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:50Z","timestamp":1787027810524,"version":"build-2736575974"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>In this retrospective study, the clinical and economic implications of microvascular reconstruction of the mandible were assessed, comparing immediate versus delayed surgical approaches. Utilizing data from two German university departments for oral and maxillofacial surgery, the study included patients who underwent mandibular reconstruction following continuity resection. The data assessed included demographic information, reconstruction details, medical history, dental rehabilitation status, and flap survival rates. In total, 177 cases (131 male and 46 females; mean age: 59 years) of bony free flap reconstruction (72 immediate and 105 delayed) were included. Most patients received adjuvant treatment (81% with radiotherapy and 51% combined radiochemotherapy), primarily for tumor resection. Flap survival was not significantly influenced by the timing of reconstruction, radiotherapy status, or the mean interval (14.5 months) between resection and reconstruction. However, immediate reconstruction had consumed significantly fewer resources. The rate of implant-supported masticatory rehabilitation was only 18% overall. This study suggests that immediate jaw reconstruction is economically advantageous without impacting flap survival rates. It emphasizes patient welfare as paramount over financial aspects in clinical decisions. Furthermore, this study highlights the need for improved pathways for masticatory rehabilitation, as evidenced by only 18% of patients with implant-supported dentures, to enhance quality of life and social integration.<\/jats:p>","DOI":"10.3390\/cancers16050974","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T07:56:02Z","timestamp":1709106962000},"page":"974","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Perfect Timing\u2014Immediate versus Delayed Microvascular Reconstruction of the Mandible"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-1487","authenticated-orcid":false,"given":"Daniel G. E.","family":"Thiem","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabia","family":"Siegberg","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-3841","authenticated-orcid":false,"given":"Shankeeth","family":"Vinayahalingam","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Blatt","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Lethaus","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre T\u00fcbingen, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8665-5803","authenticated-orcid":false,"given":"Bilal","family":"Al-Nawas","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Zimmerer","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre T\u00fcbingen, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Leipzig, Liebigstra\u00dfe 12, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peer W.","family":"K\u00e4mmerer","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/j.jcms.2015.06.034","article-title":"Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide","volume":"43","author":"Kansy","year":"2015","journal-title":"J. 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