Is a Maxillary Prosthesis More Useful than Surgical Reconstruction for Functional Recovery of Patients with Maxillary Defects？

DOI Open Access
  • SHIOIRI Shigeaki
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics
  • MURAKAMI Kazuhiro
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
  • HATA Masaki
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Removable Prosthodontics, School of Dentistry, Aichi Gakuin University
  • MIYAMAE Shin
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Gerodontology, School of Dentistry, Aichi Gakuin University
  • NAKABAYASHI Shinya
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Partial Denture Prosthodontics, Nihon University School of Dentistry
  • OHYAMA Tetsuo
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Partial Denture Prosthodontics, Nihon University School of Dentistry
  • HARAGUCHI Mihoko
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Maxillofacial Prosthetics, Division of Medical and Dental Sciences, Graduate School, Tokyo Medical and Dental University （TMDU）
  • HATTORI Mariko
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Maxillofacial Prosthetics, Division of Medical and Dental Sciences, Graduate School, Tokyo Medical and Dental University （TMDU）
  • NAKAJIMA Junko
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Removable Prosthodontics and Gerontology, Tokyo Dental Collage
  • MINAGI Yoshitomo
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
  • FUJIWARA Shigehiro
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Division of Comprehensive Prosthodontics, Niigata University, Graduated School of Medical and Dental Sciences
  • ONO Takahiro
    Clinical Practice Guideline Committee, Japanese Academy of Maxillofacial Prosthetics Division of Comprehensive Prosthodontics, Niigata University, Graduated School of Medical and Dental Sciences

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Other Title
  • 上顎欠損患者において顎義歯は外科的再建よりも機能回復に有用か？

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Background: Although maxillary prostheses have been regarded as the first choice for closure of acquired maxillary defects, their priority has become the subject of discussion because of recent advancements in reconstructive surgery. The aim of this review paper is to compare the utility of prostheses and surgical reconstruction for the functional rehabilitation of patients with maxillary defects.<br>Methods: A systematic literature survey was conducted by the Japan Medical Library Association based on keywords for PubMed and Ichushi-web presented by the Clinical Practice Guideline Committee of Japanese Academy of Maxillofacial Prosthetics. After secondary screening, related articles were extracted and their structured abstracts were created for discussion.<br>Results: Randomized controlled trials and meta-analyses were not found, and many of the searched articles were clinical studies based on an accumulation of several cases to one hundred cases. In addition to 31 extracted articles, three articles older than 1995 from the Clinical Guideline of Maxillofacial Prosthetics 2009 and three Japanese articles about the classification of maxillary defects were included in the review.<br>Conclusions: It is necessary to fully consider the type of defect （part, size, etc.）, and the number of residual teeth or related factors such as tumor therapy when choosing the prosthetic or surgical approach. Maxillary prostheses are useful in the case of partial maxillectomy which is equivalent to or less than subtotal maxillectomy with preservation of the orbital floor, unilateral defect of the hard palate and/or alveolar process, and with residual teeth in the maxilla. For larger defects and edentulous jaws, the combination of reconstructive surgery and implant is useful for functional recovery, but finally it is desirable to restore function by wearing a maxillary prosthesis after reconstructive surgery.

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