Modern Oncologic Maxillary Reconstruction | Journal CME Article-Article

Article

Pdf Summary

The document from the PRS Journal provides a comprehensive overview of oncologic maxillary reconstruction, highlighting its complexity due to anatomical and functional challenges, such as the integration of multiple tissue types, the large defect size, and the need for radiation therapy. Recent advancements have transformed maxillary reconstruction, emphasizing prosthodontic-driven solutions that incorporate bone flaps and immediate dental implants—aided by virtual surgical planning technologies.<br /><br />The article elaborates on the anatomical and functional aspects of the maxilla, underscoring the importance of understanding maxillectomy defects and their functional implications. Surgical principles are emphasized over prescriptive algorithms, recognizing that no single approach suits all patients. Oncologic context and tumor pathology are crucial for successful reconstruction, involving collaboration across multidisciplinary teams.<br /><br />Cutting-edge technologies like robotics and intensity-modulated radiation therapy are enhancing treatment paradigms, promising improved patient outcomes and survivorship. The article discusses tumor types and treatment rationales, noting that most tumors are malignant and require combined surgical and radiotherapeutic approaches. The complexity of maxillary anatomy intensifies the challenge of preserving aesthetics and function post-reconstruction.<br /><br />Reconstructive approaches include locoregional and free tissue flaps, each with specific advantages and limitations based on the type and extent of defect. The role of CAD/CAM technology in planning and executing reconstructions is vital, allowing for precise virtual modeling and execution. Despite technological advances, complications such as ectropion and fistulas persist, and achieving optimal functional and aesthetic outcomes remains a challenge.<br /><br />The document underscores the need for further research, particularly in the aesthetic outcomes of maxillary reconstruction, suggesting that while significant progress has been made, there is still room for enhancement in both technology and technique to meet patients' needs more effectively.

Keywords

oncologic maxillary reconstruction

anatomical challenges

functional challenges

prosthodontic-driven solutions

virtual surgical planning

multidisciplinary teams

intensity-modulated radiation therapy

CAD/CAM technology

aesthetic outcomes

reconstructive approaches