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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Diverse classification systems for maxillectomy defects: Simplifying or complicating the treatment plan?</title>
<author><name sortKey="Aggarwal, Himanshi" sort="Aggarwal, Himanshi" uniqKey="Aggarwal H" first="Himanshi" last="Aggarwal">Himanshi Aggarwal</name>
<affiliation><nlm:aff id="aff1">Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eachempati, Prashanti" sort="Eachempati, Prashanti" uniqKey="Eachempati P" first="Prashanti" last="Eachempati">Prashanti Eachempati</name>
<affiliation><nlm:aff id="aff2">Department of Prosthodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kumar, Pradeep" sort="Kumar, Pradeep" uniqKey="Kumar P" first="Pradeep" last="Kumar">Pradeep Kumar</name>
<affiliation><nlm:aff id="aff1">Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25991901</idno>
<idno type="pmc">4413505</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413505</idno>
<idno type="RBID">PMC:4413505</idno>
<idno type="doi">10.4103/0970-0358.155284</idno>
<date when="2015">2015</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diverse classification systems for maxillectomy defects: Simplifying or complicating the treatment plan?</title>
<author><name sortKey="Aggarwal, Himanshi" sort="Aggarwal, Himanshi" uniqKey="Aggarwal H" first="Himanshi" last="Aggarwal">Himanshi Aggarwal</name>
<affiliation><nlm:aff id="aff1">Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eachempati, Prashanti" sort="Eachempati, Prashanti" uniqKey="Eachempati P" first="Prashanti" last="Eachempati">Prashanti Eachempati</name>
<affiliation><nlm:aff id="aff2">Department of Prosthodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kumar, Pradeep" sort="Kumar, Pradeep" uniqKey="Kumar P" first="Pradeep" last="Kumar">Pradeep Kumar</name>
<affiliation><nlm:aff id="aff1">Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India</title>
<idno type="ISSN">0970-0358</idno>
<idno type="eISSN">1998-376X</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
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</teiHeader>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Yadav, P" uniqKey="Yadav P">P Yadav</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bidra, As" uniqKey="Bidra A">AS Bidra</name>
</author>
<author><name sortKey="Jacob, Rf" uniqKey="Jacob R">RF Jacob</name>
</author>
<author><name sortKey="Taylor, Td" uniqKey="Taylor T">TD Taylor</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kumar, P" uniqKey="Kumar P">P Kumar</name>
</author>
<author><name sortKey="Alvi, Ha" uniqKey="Alvi H">HA Alvi</name>
</author>
<author><name sortKey="Rao, J" uniqKey="Rao J">J Rao</name>
</author>
<author><name sortKey="Singh, Bp" uniqKey="Singh B">BP Singh</name>
</author>
<author><name sortKey="Jurel, Sk" uniqKey="Jurel S">SK Jurel</name>
</author>
<author><name sortKey="Kumar, L" uniqKey="Kumar L">L Kumar</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Aramany, Ma" uniqKey="Aramany M">MA Aramany</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Okay, Dj" uniqKey="Okay D">DJ Okay</name>
</author>
<author><name sortKey="Genden, E" uniqKey="Genden E">E Genden</name>
</author>
<author><name sortKey="Buchbinder, D" uniqKey="Buchbinder D">D Buchbinder</name>
</author>
<author><name sortKey="Urken, M" uniqKey="Urken M">M Urken</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
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</TEI>
<pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Plast Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">Indian J Plast Surg</journal-id>
<journal-id journal-id-type="publisher-id">IJPS</journal-id>
<journal-title-group><journal-title>Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India</journal-title>
</journal-title-group>
<issn pub-type="ppub">0970-0358</issn>
<issn pub-type="epub">1998-376X</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25991901</article-id>
<article-id pub-id-type="pmc">4413505</article-id>
<article-id pub-id-type="publisher-id">IJPS-48-98</article-id>
<article-id pub-id-type="doi">10.4103/0970-0358.155284</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Letters to Editor</subject>
</subj-group>
</article-categories>
<title-group><article-title>Diverse classification systems for maxillectomy defects: Simplifying or complicating the treatment plan?</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Aggarwal</surname>
<given-names>Himanshi</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eachempati</surname>
<given-names>Prashanti</given-names>
</name>
<xref ref-type="aff" rid="aff2">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kumar</surname>
<given-names>Pradeep</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
</contrib-group>
<aff id="aff1">Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India</aff>
<aff id="aff2"><label>1</label>
Department of Prosthodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia</aff>
<author-notes><corresp id="cor1"><bold>Address for correspondence:</bold>
Dr. Pradeep Kumar, Room No. 404, E Block, Gautam Buddha Hostel, King George's Medical University, Lucknow, Uttar Pradesh, India. E-mail: <email xlink:href="drpradeepkmr@gmail.com">drpradeepkmr@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jan-Apr</season>
<year>2015</year>
</pub-date>
<volume>48</volume>
<issue>1</issue>
<fpage>98</fpage>
<lpage>98</lpage>
<permissions><copyright-statement>Copyright: © Indian Journal of Plastic Surgery</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
</article-meta>
</front>
<body><p>Sir,</p>
<p>Apropos the article titled “Recent advances in head and neck cancer reconstruction” published in your esteemed journal,[<xref rid="ref1" ref-type="bibr">1</xref>
] we commend Yadav P. for putting forth an enlightening review of the progress made in the field of microvascular reconstruction techniques which are now being amalgamated with technology, for improved rehabilitation of patients following surgical treatment of head and neck cancer. Yadav P. has rightly mentioned that for maxillectomy defects, reconstruction algorithms have been individual or institute based.[<xref rid="ref1" ref-type="bibr">1</xref>
] In this regard, we opine that lack of a universally applicable/acceptable classification system for maxillectomy defects has complicated the communication and treatment planning among various specialties involved in the management of such defects.</p>
<p>There are around 14 different classification schemes for maxillectomy defects.[<xref rid="ref2" ref-type="bibr">2</xref>
] These classifications are based on the nature of the procedure performed or on the resultant tissue loss or the extent of surgical resection or by taking into consideration the prosthodontist's perspective after completion of healing.[<xref rid="ref2" ref-type="bibr">2</xref>
] However, none of the existing classifications have integrated all the factors, which are considered significant by different disciplines involved in the management of maxillectomy patients.</p>
<p>The facts worth realising are that the dental rehabilitation is not accomplished by surgical reconstruction alone and likewise, in non-reconstructed defects, implant retained/supported fixed dental prosthetic rehabilitation may not be possible. Before the advent and use of osseointegrated implants for dental rehabilitation, removable prosthetic rehabilitation with obturator was the only treatment option available for maxillectomy patients. However, placement (either primary or secondary) of osseointegrated implants in the maxilla that has been reconstructed with bone grafts has revolutionised the treatment and rehabilitation of such patients, thereby improving their quality of life.[<xref rid="ref3" ref-type="bibr">3</xref>
]</p>
<p>For successful rehabilitation, close collaboration between surgical oncologist, plastic surgeon and maxillofacial prosthodontist is necessary and for effective communication among them, a common terminology/classification is a must, to avoid confusions and ambiguity. Yadav P. has mentioned that Brown's classification is simple to use. But, as prosthodontists, we commonly use Aramany's classification since Brown's classification doesn’t adequately address the factors/issues that are of concern to us. So, when a surgeon says Class I defect (according to surgical/Brown's classification),[<xref rid="ref1" ref-type="bibr">1</xref>
<xref rid="ref2" ref-type="bibr">2</xref>
] it refers to a different defect than when a prosthodontist says Class I defect (according to prosthetic/Aramany's[<xref rid="ref4" ref-type="bibr">4</xref>
] or Okay's <italic>et al</italic>
. classification[<xref rid="ref5" ref-type="bibr">5</xref>
]), which in many situations complicates the communication. Hence there is an utmost need of a comprehensive classification system for maxillectomy defects, which takes into account the multitude of factors necessary to rehabilitate such patients and which has been critically evaluated by the managing multidisciplinary team to reach a consensus.</p>
</body>
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</back>
</pmc>
</record>
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