Background: The maxilla is a complex anatomical unit responsible for mastication, speech, swallowing, orbital support, nasal airway function, and midfacial esthetics. After maxillectomy, particularly in cases with extensive alveolar defects, simple defect closure alone is often insufficient for functional recovery, emphasizing the need for integrated skeletal reconstruction and prosthetic rehabilitation. Methods: This exploratory case series involves 10 patients who underwent computer-aided design and manufacturing (CAD/CAM) -assisted maxillary reconstruction using vascularized fibular flaps between 2019 and 2025. Surgical planning based on the buttress theory aimed to reconstruct the infraorbital rim, alveolar buttress, nasomaxillary buttress, and zygomaticomaxillary buttress. We retrospectively analyzed prosthetic goals, postoperative prosthetic status, and postoperative oral intake assessed using the Functional Oral Intake Scale (FOIS) . Results: Complete reconstruction of all buttresses was achieved for six patients, resulting in skeletal morphology comparable to that of the native maxilla. Alveolar buttress reconstruction enabled prosthetic rehabilitation in most cases. Prosthetic outcomes included removable dental prostheses, implant-supported prostheses, and ongoing prosthetic treatment for three, two, and three patients, respectively. Implant-supported rehabilitation was associated with favorable oral intake (FOIS, 6, 7) . Conclusions: CAD/CAM-assisted fibular flap-based maxillary buttress reconstruction enables anatomically oriented skeletal reconstruction and supports effective prosthetic rehabilitation, potentially improving functional and esthetic outcomes after maxillary reconstruction.
