Functional palatomaxillary reconstruction

Palatomaxillary defects are inherently more complex than defects of the mandible due to the 3-dimensional shape and the location in the midface region, at a distance from most of the recipient vessels used in free tissue transfer. However, the same reconstructive principles that have been applied in oromandibular defects can be utilized for palatomaxillary defects. The prognosis for functional recovery in these reconstructions is outstanding due to the fact that the tongue is unaffected in midface tumors. The authors review the previously introduced staging system that assists in reporting and communication, and most importantly in treatment planning. The options for management of Class 1, 2, and 3 defects are discussed in detail. Dental restoration using dental implants for support and anchorage provides the foundation for functional dental rehabilitation.