TYPES OF CLASSIFICATIONS OF MAXILLARY DEFECTS

Abstract

In recent years, a significant increase in the incidence of oncologic diseases in the oral cavity has been
detected. A special place among these diseases is held by cancer of the upper jaw, the treatment of which is mainly
surgical. As a result, maxillary defects with various size and localisation occur, which render patients` eating and
speech difficult, as well as their aesthetics. In order to evaluate the stage of damages, various classifications are
used. A review of scientific literature via Google, Scopus and PubMed shows the existence of 14 types of
classifications, which are based on different evaluation criteria. The most commonly used are the localization of the
defect and the dental status. Other classifications take into account the presence of oroantral (nasal) communication,
the degree of soft palate involvement, the height of the resection, the anterior-posterior and mid-lateral size of the
defect. Many authors do not adopt this anatomical approach and consider the creation of a moder n
classification that depicts the expected functional and aesthetic problems after resection and
provides guidelines on the type of treatment, necessary. The search for a more correct description of the
defects and the expected functional disorders after maxillary resection leads to the creation of a multitude of
classifications with several evaluation criteria. In spite of this approach, the new classifications contain plenty of
disadvantages and inaccuracies that do not provide thorough and accurate characterization of the defects. Any
attempt at correction and supplement leads to the creation of cumbersome and complex classifications that are
difficult to apply in practice. Some authors consider that optimal characterization of the defect is only possible by
combining several of the known classifications. According to others, upper jaw injuries should be
included in the general classification of maxillofacial defects . There are also opinions supporting
classifications that create an algorithm for reconstruction of the upper jaw and midface defects. However,
observations show that none of the currently used classifications fully meet surgical and prosthetic requirements, the
main reason for this being the variety of defects. The literature review examines the advantages and disadvantages
of different types of classifications of maxillary defects, as well as the possibilities of their combined application.
The possibilities of creating a single, simplified universal classification, that accurately characterizes defects and
provides guidelines on the course of treatment, are also explored.