Prosthetic Reconstruction of the Maxilla and Palate

Abstract

Maxillary defects commonly present following surgical resection of oncologic processes. The use of rotational and free flaps has largely replaced the use of prosthetic options for hard palate and maxillary reconstruction, but prostheses remain a useful tool. Prosthetic devices may be invaluable in patients considered poor candidates for surgical reconstruction secondary to poor vascularity, need for postoperative radiation, or medical comorbidities that place them at high risk for healing following reconstruction. Obturators may also be considered over soft tissue options if oncologic surveillance via direct visualization of the surgical site is warranted.

Keywords: craniofacial; facial reconstruction; maxilla; prosthesis; prosthetics.

Fig. 1

Maxillectomy defect classification. (Adapted with permission from Brown et al. 1 )

Fig. 2

Example of prefabricated surgical obturators. (Reproduced with permission from Haug. 13 )

Fig. 3

( A ) Cast with proposed margins outlined. ( B ) Prepared cast for fabrication of obturator. (Reproduced with permission from Shah et al. 27 )

Fig. 4

( A ) Interim obturator with cusps around teeth. ( B ) Interim prosthesis with the obturator portion formed from resilient lining material (white). (Reproduced with permission from Shah et al. 27 )

Fig. 5

Custom ring tray on framework. (Reproduced with permission from Haug. 13 )

Fig. 6

Soft palate speech bulb prosthesis. (Reproduced with permission from Shah et al. 27 )