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Reconstruction of the head and neck can be a challenging undertaking owing to numerous considerations for successful rehabilitation. Although head and neck defects were once considered irretrievably morbid and associated with a poor quality of life, advances in surgical technique has immensely contributed to the well-being of these patients. However, all patients are not suitable surgical candidates and many have sought nonsurgical options for functional and cosmetic restoration. As such, the advent of prostheses has ameliorated those concerns and provided a viable alternative for select patient populations. Prosthetic reconstruction has evolved significantly over the past decade. Advances in biocompatible materials and imaging adjuncts have spurred further discovery and forward progress. A multidisciplinary approach to head and neck reconstruction focused on appropriate expectations and patient-centered goals is most successfully coordinated by a team of head and neck surgeons, maxillofacial surgeons, and prosthetic specialists. The aim of this article is to provide a comprehensive review of the current trends for prosthetic rehabilitation of head and neck defects, and further elaborate on the limitations and advancements in the field.

Maxillofacial prosthetics refers to an area of dentistry dedicated to the restoration of skull base and maxillofacial defects acquired from tumor ablative surgery, trauma, or congenital defects. Anatomically, the skull base is complex and conceptually intricate due to its three-dimensional (3D) morphology. Although once considered a defect area prone to significant morbidity and poor quality of life, surgical advancements over the past decade have helped curb these fears. Prostheses have proven to be a valuable adjunct in skull base reconstruction, as these can restore function and cosmesis. The goal of this review article is to highlight current options for prosthetic rehabilitation of skull base defects with an emphasis on the advancements and limitations in the field of prosthetic reconstruction. Preoperative PlanningPatients undergoing treatment for skull base tumors often require interdisciplinary collaboration between several clinical specialties to receive comprehensive management. 1 Presurgical planning involves a concerted dialogue between the surgeons and the various disciplines of speech therapy, medical oncology, and radiation oncology. This patient population requires special needs not only for treatment but also for reconstruction and follow-up care. Prior to ablative surgery, the maxillofacial prosthodontist should be consulted to offer input regarding a patient's capacity for functional rehabilitation. Keywords► skull base defects ► tumor ablative surgery ► osseointegrated implants ► prosthetics AbstractRehabilitation following ablative skull base surgery remains a challenging task, given the complexity of the anatomical region, despite the recent advances in reconstructive surgery. Remnant defects following resection of skull base tumors are often not amenable to primary closure. As such, numerous techniques have been described for reconstruction, including local rotational muscle flaps, pedicled flaps with skin paddle, or even free tissue transfer. However, not all patients are appropriate surgical candidates and therefore may instead benefit from nonsurgical options for functional and aesthetic restoration. Osseointegrated implants and biocompatible prostheses provide a viable alternative for such a patient population. The purpose of this review serves to highlight current options for prosthetic rehabilitation of skull base defects and describe their indications, advantages, and disadvantages.

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