Maxillary reconstruction.

Postablative maxillary defects present a wide range of functional and esthetic challenges. Several classification schemes have added clarity to the subject, but the surgeon must maintain a clear vision of the defect and appreciate its reconstructive implications. Local tissue flaps remain valuable tools in the reconstruction of small isolated defects of the posterior maxilla and palate; however, microvascular free flaps have eclipsed prosthetic obturators as the mainstay of therapy in advanced postablative defects of the maxilla. Many excellent microvascular options exist and the overall objectives remain to preserve oral function in accordance with the needs of the patient.