Reconstruction of the Maxillectomy Defect

Purpose of Review: Maxillectomy for ablative surgery results in defects with significant functional and cosmetic morbidity. The hard or soft palate, dental arch, alveolus, nose, zygoma, malar process, or orbits may be involved, each with attendant considerations. Prosthodontic rehabilitation with a metallic and acrylic obturator has classically been used to replace missing teeth and separate the oral cavity from the nasal cavity and maxillary sinuses. Microvascular free tissue transfer has emerged as the current mainstay of treatment for patients needing composite reconstruction, especially where bony support is needed. Recent Findings: Technical refinements in skin paddle design, muscle flap orientation, and bone fixation have dominated the literature over the past two decades. Recently, advances in microvascular techniques using virtual surgical planning and navigation-guided implant surgery have improved predictability of dental rehabilitation. Summary: The current state of the art remains comprehensive functional and cosmetic rehabilitation, comprising facial support, definitive obturation of the oronasal and/or oroantral defect, and functional dental occlusion. © 2016, Springer Science+Business Media New York.