The maxilla is the key structure in the midface, forming part of the orbit, nasal cavity, and oral cavity. It plays a critical role in maintaining facial aesthetics and essential functions (Breeze et al., 2016). Damage to the maxilla caused by tumors, trauma, or other factors can disrupt vital physiological processes such as vision, nasal airflow, speech, and mastication. Additionally, maxillary destruction often leads to facial deformities, which can have a profound negative impact on a patient's psychological well-being. As a result, reconstructing the maxilla to restore both its form and function remains a significant challenge in clinical practice.

Maxillofacial prostheses, known for their simplicity and shorter surgical time, have traditionally been employed in maxillary reconstruction, particularly for patients who are not candidates for extensive surgical procedures (Fig. 1). However, their application is limited by several drawbacks, including challenges in cleaning, poor retention in large defects, and an increased risk of nasal regurgitation (Futran et al., 2006; Pool et al., 2020). As a result, current clinical practices emphasize autologous tissue reconstruction as the preferred approach for managing large maxillary defects (Brown and Shaw, 2010; Steel and Cope, 2015). This method involves the use of free soft tissue flaps, bone flaps, or composite flaps. Commonly used bone flaps include the fibula, scapula, and iliac crest osteocutaneous flaps (Iyer et al., 2014). The vascularized iliac crest free flap, first introduced by Taylor et al., in 1979 (Taylor et al., 1979), was later recommended by Brown et al. as the ideal option for reconstructing extensive midfacial defects (Brown, 1996). Although literature suggests that the natural curvature of the iliac crest closely resembles that of the maxilla, providing sufficient bone volume for implant placement and a suitable caliber for microvascular anastomosis through the deep circumflex iliac artery (DCIA) (Taylor et al., 2016), the theoretical and anatomical evidence supporting this similarity remains limited.

The maxilla, connected to adjacent bones through sutures, forms three paired buttress structures that help distribute masticatory forces and resist external impacts. The canine buttress, also known as the nasofrontal buttress, primarily bears the masticatory load in the canine region. It originates from the alveolar process of the maxillary canine region, ascends along the lateral border of the piriform aperture and the medial orbital rim, and extends through the frontal process to the frontal bone. This structure plays a crucial role in supporting the corner of the mouth and maintaining normal facial contours. Therefore, restoring both the form and occlusal function of the maxillary canine region is essential. The iliac tubercle, a lateral prominence and the thickest part of the iliac crest (Ebraheim et al., 1997; Thein et al., 1997; Zaker Shahrak et al., 2014), is hypothesized to have a physiological curvature and thickness similar to those of the maxillary canine region. This raises the question of whether the iliac tubercle could serve as a viable option for repairing defects in the maxillary canine region. To address this, we plan to collect patient CT data for modeling and measurement analysis to evaluate the anatomical feasibility of using the iliac tubercle for this purpose, followed by validation of the approach through surgical practice.