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.
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.
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.
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.