In my case, before removing the cancerous portion, they anchored the chin and the hinge on the left side together with a titanium strap.

On an xray, it looks a bit like a bicycle chain; full of holes. the reason for doing that is allignment; if they removed the canerous portion first, the muscles in the face and jaw would torque everything off to the side, and they couldn't re-align things properly.

Once the bad stuff was removed, they sculpted pieces of bone, and placed them behind the titanium. Initially they were held in place with staples (internally...they are still there) but they collect bone dust from the fibula removal, and pack it in, and around the titanium plate.

Over time, the bone (which also had tissue and blood supply brought along) actually grows and migrates into the openings in the titanium, making the two elements effectively one.

I had a panographic xray done a few months ago, and it's pretty cool to see what they did. Everything has healed up very well. YOu really wouldn't know I had that much done if I didn't point out the scars to you.

It is very strong, even right after surgery. My mouth was never wired, or retained. I woke up able to talk , and had food orally within a week.
Wayne