Maxillary reconstruction: Functional and aesthetic considerations

Maxillary reconstruction is a challenging endeavor in functional and aesthe tic restoration. Given its central location in the midface and its contribu tions to the key midfacial elements-the orbits, thr zygomaticomaxillary com plex, the nasal unit, and the stomatognathic complex-the maxilla functions as the keystone of the midface and unifies these elements into a functional and aesthetic unit. Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxi llary defects are composite in nature, and they often require skin coverage , bony support, and mucosal lining for reconstruction. In the reconstructio n of maxillary defects secondary to trauma, ablative turner surgery, or con genital deformities, the following goals must be met: (1) obliteration of t he defect; (2) restoration of essential functions of the midface, such as m astication and speech; (3) provision for adequate structural support to eac h of the midfacial units; and (4) aesthetic reconstruction of the external features. This review will discuss the pertinent anatomic considerations, t he historical approaches to maxillary reconstruction, and the merits of the techniques in use today, with an emphasis on state-of-the-art reconstructi on and dental rehabilitation of extensive maxillary defects.