The most frequent causes of maxillary bone involvement are due to cancer or trauma resections. In many of these cases, reconstruction with tissue from another part of the body is necessary with the help of microsurgery. The objectives of this reconstruction are: the primary closure of the surgical wound, avoid the formation of fistulas or abnormal communications between cavities, maintain the floor of the orbit (which holds the eye), provide well-vascularized bone to place dental implants, and maintain the projection of the cheekbone and the nose.
Flaps frequently used in this type of reconstruction are the fibula flap and the anterolateral thigh perforator flap. The advantage of the fibular flap versus other types of bone flaps is that it can be adapted very well to the defect and it is possible to place osseointegrated implants. The advantage of the anterolateral thigh perforator flap is that the minimum morbidity of the donor area and the versatility of its design.
This reconstruction should ideally be performed by a team specialized in microsurgical reconstruction, with appropriate training and focused before and during surgery only to rebuild.