Reconstructive options for maxillary defects.

Reconstruction of the maxilla should aim to restore appearance, speech and occlusion. With modern reconstructive techniques and availability of an increasing variety of reliable tissue flaps, many of the traditional problems of treatment have been overcome. This paper reviews local and distant tissue flaps useful in rehabilitating an acquired maxillary defect of various dimensions. The local flaps discussed include flaps from the palate, cheek, tongue and the buccal fat pad. The distant flaps considered are the temporalis myofascial flap, pedicled cutaneous and myocutaneous flaps, and vascularized free flaps. Bony reconstruction of the maxilla with particular emphasis on restoring an anatomical alveolar ridge for occlusal rehabilitation by dental implants is presented.