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Clinical Maxillofacial Prosthetics

Preface:
The subspecialty of maxillofacial prosthetics currently finds itself experiencing more change than at any other time over the past 50 years of its recognized existence. Advances in surgical and therapeutic modalities for the treatment of patients with head and neck malignancy, post-tumor therapy surgical reconstruction, and congenital and developmental defects have challenged traditional prosthodontic principles for the management of the many patients needing our services. The ranks of those providing traditional maxillofacial prosthetic services have expanded to include prosthodontists, general and hospital dentists, and others not formally trained in the subspecialty. The practice of maxillofacial prosthetics has also been dramatically impacted by third parties not directly involved with the provision of patient care but whose activities dramatically affect our ability to treat. These concerns, changing treatment philosophies and methods, and the challenge of practicing maxillofacial prosthetics in private practice as well as in institutional environs were the impetus for creating this book. A conscious decision was made to focus on the 'how to' rather than the historical basis for treatment or the medical background of involved disease processes. A number of excellent texts have been written on the subject of maxillofacial prosthetics. By review of my own library, at least nine full texts have been dedicated to the subject in the past 50 years. They have addressed the subspecialty and have to a greater or lesser degree also dealt with the medical management of patients whose circumstances require maxillofacial prosthetic care. The drawback of this approach has been a tendency to oversimplify medical/surgical treatment or to narrowly focus on the therapeutic philosophy and protocol of specific medical centers without addressing the full extent of accepted treatment modalities and philosophies. Medical/surgical modalities for the treatment of congenital, developmental, and acquired maxillofacial defects frequently change so rapidly that the therapies described in texts on maxillofacial prosthetics are often outdated by the time the book is published. To address these problems, this book has been written with a focus on the prosthodontic aspects of care for our patient population. For a review of the etiology, pathology, or therapeutic management for a specific type of tumor or congenital defect, the reader is directed to books or journals that deal primarily with such procedures. This book is an in depth review of prosthodontic procedures as they are applied in the maxillofacial situation. The subspecialty of maxillofacial prosthetics is frequently practiced by prosthodontists and occasionally by general dentists in a hospital environment who have not had the benefit of formal training in the subspecialty. It is hoped that this book will be of use to those individuals by serving as a 'how-to' reference emphasizing prosthodontic procedures while minimizing surgical/medical considerations that can more appropriately be found elsewhere. To that end, Clinical Maxillofacial Prosthetics is written as a user's guide to commonly occurring maxillofacial prosthetic challenges. This approach is based upon careful discussion of both general and specific prosthodontic principles and techniques rather than on numerous case reports of limited value to the general reader. I would like to acknowledge the various chapter authors, some 25 of them, whose efforts have made this text an outstanding contribution to the subspecialty. Each author was recruited because of recognized expertise in a particular topic area. I am indebted to their dedication, their interest, and their energy in making this text a reality and in making it such a substantial addition to the prosthodontic literature. Heartfelt thanks to each and every one.