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Abstract：
Surgical reconstruction after a total maxillectomy remains challenging. The standard treatment is the microvascular free flap. In cases of surgical contraindication, oral rehabilitation is usually performed with a palatal obturator prosthesis (PAP). Acceptable anatomical and functional outcomes in terms of speech, mastication, aesthetic appearance, stability, and comfort are not often achieved with a PAP. This technical note describes a technique for reconstruction after total bilateral maxillectomy involving the implantation of a custom-made bone-anchored titanium prosthesis obtained by 3D printing. Good functional and anatomical outcomes were achieved with this technique. It combines the advantages of the obturator prosthesis (short duration of surgery and hospitalization, low morbidity) and free flap (aesthetic/anatomical reconstruction and irremovable comfortable functional rehabilitation). This technique constitutes a new therapeutic alternative for the restoration of large defects after total maxillectomy when free flaps are contraindicated.
摘要：
上颌骨全切除术后的外科重建仍然具有挑战性。标准治疗是微血管游离皮瓣。在手术禁忌症的情况下，口腔修复通常使用腭闭孔假体(PAP)进行。在言语方面可接受的解剖和功能结果，咀嚼,美观的外观，稳定性,和舒适度通常不是用PAP实现的。本技术说明描述了一种在双侧上颌骨全切术后重建的技术，该技术涉及植入通过3D打印获得的定制的骨锚钛假体。该技术实现了良好的功能和解剖学结果。它结合了闭孔假体的优点（手术和住院时间短，低发病率）和游离皮瓣（美学/解剖学重建和不可移除的舒适功能康复）。当禁忌使用游离皮瓣时，该技术为全上颌切除术后修复大缺损提供了一种新的治疗方法。
