Scalpel Society X Tooth Be Told: Seminar on Reconstructive Jaw Surgery

On April 8th, Scalpel Society, in collaboration with the newly formed dentistry club Tooth Be Told, had the pleasure of hosting Dr. Jordan Gigliotti at Marianopolis College. Dr. Gigliotti, a specialist in Oral and Maxillofacial Surgery (OMF), shared his insights on the evolution of reconstructive jaw surgery, comparing historical approaches with cutting-edge modern techniques.

It was a packed seminar, with students eager to learn about this unique and often underrepresented medical specialty. Dr. Gigliotti’s engaging presentation offered a rare glimpse into the surgical challenges and innovations involved in restoring both function and aesthetics to the jaw.

The goal of this seminar was to highlight the depth, complexity, and importance of OMF surgery, and to inspire greater awareness of this fascinating field among aspiring healthcare professionals.

Seminar Abstract:

Mandibular reconstruction aims to restore the lower jaw’s form and function, which is essential for aesthetics, mastication, speech, swallowing, and oral competence. Historically, surgical techniques were limited by the absence of anesthesia and antibiotics, but major advances in the 20th century, including the introduction of ether anesthesia and penicillin, enabled the development of reconstructive strategies using bone grafts and fixation materials. Dr. Gigliotti traced the evolution from early bone grafting methods to landmark innovations such as the fibula flap and modern digital workflows like “Jaw in a Day.”

The seminar reviewed current treatment modalities, from collapsing the defect in medically fragile patients to using gap-bridging plates, alloplastic reconstruction, non-vascularized bone grafts, and vascularized free tissue transfer. Collapsing the defect, while occasionally indicated in terminal patients, leads to severe functional deficits such as the “Andy Gump” deformity. Gap-bridging plates can serve as temporary solutions but are prone to complications like plate exposure and mechanical failure, especially in anterior defects. Alloplastic reconstructions, though conceptually promising, remain experimental and carry significant risks.

Non-vascularized bone grafts, both autogenous and engineered, are appropriate for select benign or traumatic cases with good soft tissue integrity. Tissue engineering was highlighted as a promising future direction, focusing on the triad of cells, scaffolds, and signalling factors to regrow bone. Vascularized free flaps, especially from the fibula, scapula, and iliac crest, are currently the gold standard due to their reliability and versatility, supporting both hard and soft tissue reconstruction and facilitating dental rehabilitation.

Dr. Gigliotti concluded that there is no single optimal technique; rather, successful mandibular reconstruction requires careful consideration of defect characteristics, patient health, and institutional capabilities. Tailoring the approach to each case ensures the best functional and aesthetic outcomes.