The 38th Annual Meeting of the Japanese Society of Oral and Maxillofacial Prosthodontics was held in June 2021 under the auspices of the Department of Prosthodontics, School of Dentistry, Ohu University, as the first online meeting in the history of the society.
The symposium “Maxillofacial Prosthetic Treatment in Hospital Dentistry” was organized by Dr. Tetsuo Yamamori, President of the meeting, and three presenters introduced their approaches to multidisciplinary cooperation from the standpoint of their respective institutions. Three symposiasts then discussed the problems and solutions of maxillofacial prosthetic treatment in hospital dentistry.
A common problem in hospital dentistry is that maxillofacial prosthetics is part of the overall work of hospital dentistry. Therefore, there are various constraints on maxillofacial prosthetic treatment, such as time, manpower, technology and geography.
Suggested solutions to this problem were: the inclusion of dental practice in the clinical path, the effective use of clinic time, exchanges with other institutions, participation in hands-on seminars, dispatch of maxillofacial prosthetists from university hospitals, development of local core leaders, and enhancement of online conferences and seminars.
It seems necessary to consider the improvement and enhancement of maxillofacial prosthetic treatment in hospital dentistry in order to promote it widely.

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It has been a long time since the importance of the team approach and multidisciplinary cooperation was advocated. In patients with head and neck cancer, a team approach is essential not only for the treatment of the tumor but also for the subsequent morphological and functional recovery. There have been many reports on the establishment and implementation of interdisciplinary maxillofacial rehabilitation systems in university hospitals, but there are few such reports in general hospital dentistry.
Our department provides dental care to support acute care in the hospital. The role of our department is to provide comprehensive treatment, including prevention of oral complications by dental means and improvement of feeding, swallowing, occlusion, and speech. We also provide specialized dental care such as the fabrication of maxillofacial prostheses for patients with head and neck cancer, and training and assistive devices for patients with dysphasia. We consider that maxillofacial prosthetic treatment has both rehabilitation and plastic surgery aspects, and that broadening the scope of indication can improve the patient’s QOL. We would like to continue to explore the activities of our institution.

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Our hospital is the regional core hospital in the Pacific coastal region of Fukushima prefecture. As our hospital has departments of oral surgery, otorhinolaryngology and head and neck surgery, and plastic surgery, there are many patients needing maxillofacial prosthetic treatments. However, it is more difficult to receive treatment in regional cities than in a metropolis, and visiting a distant university hospital for treatment places both an economic and physical burden on patients. Recently, due to population aging, treatment requires community-based medical care. This paper describes the facts and problems of maxillofacial prosthetic treatment in our regional core hospital and considers the future prospects of treatment in cooperation with general practitioners of dental clinics in the same area.

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Although maxillofacial prosthetic treatment aims to restore functional disorders in mastication, the functional disorders and their associated severity, as well as the defect shapes, differ due to the wide variety of diseases. This review describes the tasks under the theme “Problems and prospects of maxillofacial prosthetics at medical universities.” First, in our hospital, the surgeon is a medical doctor and the maxillofacial prosthodontist is a dentist. To share important information that is necessary for treatment, meetings should be held regularly; however, this is not currently the situation. Second, dentists who are not accustomed to prosthodontics must perform maxillofacial prosthetic treatments. Third, there are also locational issues, i.e., it is not easy to refer patients to another maxillofacial prosthodontist. Finally, further dental education is needed to accomplish multidisciplinary collaboration in maxillofacial prosthetics. We intend to devise new strategies to solve these problems.

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The Japanese Academy of Maxillofacial Prosthetics has released the 2019 edition of the Clinical Practice Guideline, which is an update of the 2009 edition in a format compliant with the GRADE system. This guideline consists of one clinical question （CQ） as a foreground question and seven questions and answers （QAs） as background questions. The CQs provide recommendations and explanations, and the QAs provide answers and overviews of maxillofacial prosthetic treatment.
The reason why there is only one CQ in this guideline is that the maxillofacial prosthodontics field has many case reports and case-concentration studies due to the small number of cases, and it is difficult to conduct systematic reviews and meta-analyses.
In the future, professional societies in this field should promote multi-center collaborative research and the like as a basis for establishing evidence.

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