A new application of a screw-plate for prosthetic reconstruction after bilateral total maxillectomy.

Satisfactory functional and aesthetic rehabilitation of a patient after total bilateral maxillectomy is a great challenge to the surgeon and prosthodontist. A particular problem is support and retention of the obturator. In the case described, the problem was solved by attaching the prosthesis with finger clasps to a classic AO-reconstruction plate anchored rigidly with screws to both zygomata. The results in terms of mastication, swallowing, phonation and aesthetics were satisfactory for more than 2 years, when the patient died from brain metastasis and pneumonia. The technique seems promising and merits further study using titanium screws and plates.