Prosthetic management of the maxillectomy patient

If maximal preservation of appearance and function are to be achieved for the maxillectomy patient, preoperative dental impressions should be obtained, and clear communication should be established between the surgeon and the prosthodontist. The immediate surgical splint, which can be used for edentulous as well as dentulous patients, provides numerous advantages for the patient and the surgeon. Surgical procedures that enhance the fit and comfort of a prosthesis include (1) making the mucosal incision 0.5 cm lateral to the bony cut, (2) extracting the first tooth on the resected side before making the bony cut, (3) preserving the premaxillary segment, (4) creating a skin-graft mucosal-scar band, (5) removing the entire velum when the surgical procedure requires resection of more than one-half of the velum, and (6) evaluating the possible removal of the coronoid process.