What Is the Maxilla?

The maxilla is a pair of fixed air-containing bones, located on both sides of the nasal cavity, making up most of the sub-facial portion.

The maxilla is a pair of fixed air-containing bones, located on both sides of the nasal cavity, making up most of the sub-facial portion.

Chinese name

Maxilla

Foreign name

maxilla

Pinyin

shàng hé g

Complex

Maxilla

Maxillary anatomy and composition

The maxilla constitutes a bracket in the middle of the face, one on the left and one on the left, symmetrical to each other, and composed of one body, four processes, and four sides.

The hollow body is the maxillary sinus, which communicates with the frontal sinus, nasal sinus, and ethmoid sinus, and has a function of dispersing and buffering. In order to adapt to the load on the force, the maxillary bone is arranged in the direction of stress conduction in the part where the force is greater, so that the bone is thickened into three pairs of bone columns: frontal column: starting from the maxillary canine , Rising through the inner edge of the orbit to the frontal bone. The force mainly supports the canine area. Condylar column: It starts from the first molar and rises through the outer edge of the orbit to reach the frontal bone. Its branches travel backward from the outer edge of the orbit and reach the skull base through the zygomatic arch. The force mainly supports the first molar area. Pterodactyl column: It is composed of sphenoid pterygoid. Together with the maxillary tubercle, the force in the molar area is supported. The maxilla and its adjacent bones also constitute a supraorbital arch, suborbital arch, supranasal arch, subnasal arch, maxillary arch, and zygomatic arch similar to the mechanical arch structure. These arched structures are symmetrical to the left and right, which is conducive to the dispersion and cancellation of the force. Therefore, although the maxilla is composed of a thin bone plate, it is strong and capable of bearing forces without damaging the brain.

The blood flow of the maxilla is abundant, so when the maxilla is fractured, although the bleeding is more, it is easy to heal. As far as the entire maxilla is concerned, its nasal surface, orbital surface, maxillary sinus, condyles, and alveolar processes are all weak links, which are the common sites of fractures. The inferior wall of the maxillary sinus covers the apical region of the premolars and molars from front to back, and the apex of these teeth is only separated by thin bone or only by the mucous membrane, so it is easy to produce odontogenic maxilla. Sinusitis. When removing the root or broken root, it is easy to cause oral maxillary sinus fistula, and even push the broken or residual root into the maxillary sinus.

Maxillary related diseases and treatment

1. The maxillary bone is the most important skeletal structure in the shape and function of the face. The maxillary defect caused by various causes seriously affects the shape of the maxillofacial region, as well as important physiological functions such as language, chewing and swallowing. The repair and reconstruction of maxillary defects is a complex task facing both oral and maxillofacial surgeons and prosthetics. Local tissue flaps and pedicled tissue flaps are limited by the size, shape, and location of the tissue flaps, and have limited repair results. Microsurgical technology is considered to be the third leap in the history of maxillofacial defect repair. The application of various free flaps has made the functional reconstruction of the maxilla mature.

2. Maxillary defects are divided into 4 categories according to the range of vertical defects:

One type of defect is maxillary defect without oral maxillary sinus fistula, including alveolar process defect and simple hard palate defect;

The second type of defect is the defect after maxillary resection, including the alveolar process and the maxillary sinus wall, but not the orbital floor;

The three types of defects are those after high resection of the maxilla, including the orbital floor;

The four types of defects are those caused by radical maxillary resection, including eyeballs. According to the extent of horizontal or palatal defects, 2 to 4 types of defects can be divided into categories a, b, and c3: category a is unilateral alveolar process and hard palate defect; category b is bilateral alveolar process and hard palate defect; Type c is the entire alveolar process and hard palate defect.

3. Repair methods: The repair methods of maxillary defects are divided into free flap repair, non-free flap repair, prosthetic repair and unrepair. Among them, non-free flap is divided into local flap, pedicled flap and free bone graft. . The prostheses are divided into palatal prostheses, removable dentures (repairing type 1 alveolar process defects), palatal brackets (repairing simple palatal defects) and simple palatal brackets (prefabricated palatal brackets before surgery).

4. Free composite tissue flap combined with implant implantation to rebuild the superiority of the maxilla. Autogenous tissue repair of maxillary defects! In the early days, various pedicled or free soft tissue flaps such as pectoralis major skin flaps were used to fill the maxilla. "Dead cavity at the bone defect" Although this type of repair method overcomes the shortcomings of the prosthetic prosthesis method to a certain extent, it still has serious defects because it is only for soft tissue repair! Cannot be used for dental implants and dentures At the same time, due to the soft tissue surface, chewing function cannot be performed after wearing conventional dentures. The application of free composite bone flap combined with titanium stent "overcame the shortcomings of simple soft tissue titanium stent for maxillary bone repair" and finally restored the patient's mastication function by implanting implants in the graft bone and performing denture repair.