Surgery for palate lesions may result in oro-nasal/antral communication, which reduces a person\'s quality of life by affecting swallowing, speech, and food reflux. The shape and size of this obturator prosthesis might vary based on the severity of the defect. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis and generalized attrition of teeth using an obturator and full mouth rehabilitation.

UNASSIGNED: The phenomenon of vessel pedicle ossification is a noteworthy aspect of the repair and reconstruction of maxillofacial defects. Imaging findings typically reveal high-density shadows within the vascular pedicle pathway, which may be managed through conservative observation or surgical intervention as deemed appropriate.
UNASSIGNED: Vessel pedicle ossification is a relatively uncommon complication associated with the reconstruction of oral and maxillofacial tissue defects using free tissue flap repair. In this paper, we report a case of pedicle ossification and conduct a comprehensive review of previous literature. A 39-year-old man presented with a limited ability to open his mouth 6 months after fibular flap reconstruction of the mandible. Plain film X-ray and computed tomography (CT) indicated pedicle ossification. Two years after the initial operation, the restriction in the patient\'s ability to open his mouth had not worsened, although there were more pronounced radiographic abnormalities.

Over the years, several bone regeneration procedures have been proposed using natural (autografts, allografts, and xenografts) and synthetic (i.e., metals, ceramics, and polymers) bone grafts. In particular, numerous in vitro and human and animal in vivo studies have been focused on the discovery of innovative and suitable biomaterials for oral and maxillofacial applications in the treatment of severely atrophied jaws. On this basis, the main objective of the present narrative review was to investigate the efficacy of innovative collagenated porcine bone grafts (OsteoBiol®, Tecnoss®, Giaveno, Italy), designed to be as similar as possible to the autologous bone, in several bone regeneration procedures. The scientific publications were screened by means of electronic databases, such as PubMed, Scopus, and Embase, finally selecting only papers that dealt with bone substitutes and scaffolds for bone and soft tissue regeneration. A total of 201 papers have been detected, including in vitro, in vivo, and clinical studies. The effectiveness of over 20 years of translational research demonstrated that these specific porcine bone substitutes are safe and able to improve the biological response and the predictability of the regenerative protocols for the treatment of alveolar and maxillofacial defects.

Ablative surgery of midface often leads to compromised aesthetics as well as function. Defects caused by ablative surgery need reconstruction that provides satisfactory results with minimal or no compromise in form and function. Various flaps can be used to reconstruct the maxillary defect. However, medium to large-sized defects can only be appropriately reconstructed using free or regional flaps. Moreover, as free flap reconstructions are tedious and require technique sensitive procedure whereas loco-regional flaps are versatile and more predictable. Temporalis myofascial flap (TMF) seems to be one of the best options among all other regional flaps as it has a reliable blood supply, adequate bulk and its anatomical location is close to primary defect.

OBJECTIVE: To assess the ability of prosthetic rehabilitation versus surgical rehabilitation in improving the QOL for patients with maxillary defects.
METHODS: A systematic search of PubMed, Scopus data base, Cochrane database, Ovid database, and Latin America & Caribbean database for articles published before September 2017 was performed by two independent reviewers. A manual search of articles published from January 2000 to September 2017 was also conducted. Only English studies were included which evaluate the QoL in patients with head and neck cancers. Any confusion between the two independent reviewers was resolved by means of a moderated discussion between the reviewers.
RESULTS: Five studies fulfilled the inclusion criteria for this study. Many parameters were used regarding evaluation of QOL as the EORTC Head and Neck 35 assessment, UW-QOL, OHIP-14, VAS, OFS, MHI, HAD, Body Satisfaction Scale, Oral symptom check list, Swallowing, Diet consist, Pain control, Postoperative complication, and Speech. Two studies supported the surgical line of treatment for improving the QOL as compared to the prosthetic one; another two studies showed a statistically insignificant improvement in the patients\' QOL with the surgical line, while only one revealed insignificant difference in QoL with both lines of treatment.
CONCLUSIONS: Surgical rehabilitation provides a better line of treatment in improving the QOL for patients with maxillary defects. On the other hand, prosthetic has proved effectiveness in the immediate post-surgical times as temporary strategy, and it has represented a good alternative when the surgical obturation is compromised.

BACKGROUND: Recent studies have highlighted that MSCs are capable of regenerating large bone defects when used in combination with bone substitutes and increasing allo-graft osteointegration. We investigated the hypothesis that autologous MSCs may lead to increased bone regeneration and reduced healing time in post-surgical cavities of large maxillary bone lesions.
METHODS: This study involved 10 patients (TEST GROUP) (6 males and 4 females). All patients had expansive mandibular lesions larger than 3 cm. From the surgical point of view, the 10 patients were treated with MSCs (withdrawal of the iliac crest bone marrow BMMSs) directly into the post-surgical cavity, without the addition of filler.
RESULTS: and radiological data, in the postoperative, were compared to those of patients who did not receive any grafting of MSCs. The 7 patients with mandibular lesions showed a rapid and very good healing with an 85-90% ossification of the major defect at 12 months.
CONCLUSIONS: Through the use of stem cells a greater ossification of the residual cavity (85-90%) was observed at 12 months after surgical enucleation in contenitive defects.

BACKGROUND: Maxillary defects are managed by prosthodontic rehabilitation using obturators. This rehabilitation goes through various stages, which invariably affects the quality-of-life of the patients.
OBJECTIVE: This study aims to analyze the types and design of obturators used in the rehabilitation of maxillary defects at a tertiary health institution in Nigeria.
METHODS: This is a retrospective study of all patients with maxillary defects treated at a tertiary institution between the period of October 2010 and May 2013. The data of interest collected from the patient\'s register and case notes include age, gender, type of defects, design of obturators and conditions for which treatment was offered. The collected data were analyzed using Statistical Package for Social Sciences version 16.0 (Chicago, Illinois, 2010) and result presented in frequencies and tables.
RESULTS: A total of 19 case notes were retrieved. The age range was 5-73 years with the mean age of 46.37 ± 19.02 and peak age incidence at 41-60 years. The male: female ratio was 1:1.4. Surgical defects were the most common type of maxillary defects seen; accounting for 89.5% (17/19) of the cases, which were mostly associated with malignant tumors. Immediate surgical obturators were provided for 63.2% (12/19) of the subjects. Majority 70.6% (12/17) of those with surgical defects received immediate surgical obturators while all those with congenital defect were given feeding plate. There was a statistically significant association between the type of maxillary defect and type of obturator provided (P < 0.01).
CONCLUSIONS: The results of this study suggest that majority of the obturators fabricated for patients with maxillary defect at the Tertiary health institution in Nigeria were immediate surgical obturators. Pre-surgical patient education and follow-up care is advocated.

BACKGROUND: Defects of the maxilla due to tumor extirpation can create accordingly high levels of psychological and physical trauma for patients and their families. However, the reconstruction of maxillary defects remains very challenging. Today, using autogenous bone grafts and dental implants is an effective method to restore maxillary defects.
OBJECTIVE: The purpose of this study was to evaluate the long-term clinical outcomes of maxillary rehabilitation with dental implants after tumor resection. Patient satisfaction after maxillary reconstruction was also assessed with regard to function and comfort.
METHODS: Over a 6-year period (2000-2005), 24 patients with maxillary tumors underwent resection with either immediate (n = 18) or delayed reconstruction or underwent prosthetic rehabilitation (n = 6).The patients received 88 implants in total, including 9 zygomatic and 79 conventional implants, for maxillary rehabilitation of the defective areas.
RESULTS: Autogenous bone grafts were successful in all patients, although partial loss of the graft was observed in one patient who received an iliac graft. Patient follow-up was started at the point of the prosthetic loading of implants. The median treatment time was 99.1 months (range:18-137 months). One patient died after 18 months of follow-up due to tumor recurrence, and two patients were lost to follow-up after 3 years of observation. Ten conventional dental implants were removed due to peri-implantitis. Six patients chose implant-supported obturators. The cumulative survival and success rates of the implants were 88.6 and 86.3%, respectively.
CONCLUSIONS: This study demonstrated that the rehabilitation of maxillary defects following tumor resection using implant-supported fixed prostheses with autogenous bone grafts or prosthetic rehabilitation is successful and is associated with high patient satisfaction. Oral function can be restored using dental implants for patients with maxillary defects.