Modified vestibuloplasty of the zygomaticoalveolar crest to gain intradefect support for an obturator prosthesis

Abstract PurposeTo evaluate the effectiveness of the prosthetic rehabilitation, as well as the quality of life (QOL) of older edentulous maxillectomy patients.MethodsEffectiveness of the complete denture obturator prosthesis and QOL of 44 older patients who had resection of the maxilla and were restored with a definitive prosthesis that was in use for minimum 1 year was assessed using 3 instruments: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), Head and Neck Cancer Module (QLQ-HN35), and Obturator Functioning Scale (OFS). Data analysis was performed by the one-way ANOVA on ranks, Spearman rank order correlation, and hierarchical multivariable rank regression at α=.05 level of significance.ResultsParticipants’ gender (P<.001), adjuvant treatment (P =.016), surgical approach (P =.017), size of the maxillary defect (P=.028), participants’ prosthetic history (P =.047), and dental status of the mandible (P =.038) were significantly related to the self-reported effectiveness of the obturator. Perceived functioning of the complete denture obturator prosthesis (P=.001), participants’ gender (P=.002), the American Society of Anesthesiologists (ASA) physical status (P=.027), and surgical approach (P=.039) were significant predictors of QOL. ConclusionRestoration of the edentulous maxillectomy defect is challenging. An effective definitive complete denture obturator appeared to be the strongest predictor for advanced quality of life in older maxillectomy patients. The physical status of the older participants significantly affected the overall QOL, but did not influence the self-reported functioning of the complete denture obturator prosthesis.

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Obturator Prosthesis Rehabilitation after Maxillectomy: Functional and Aesthetical Analysis in 25 Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312524 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12524

Author(s):

Massimo Corsalini ◽

Giuseppe Barile ◽

Santo Catapano ◽

Annamaria Ciocia ◽

Assunta Casorelli ◽

...

Keyword(s):

Surgical Resection ◽

Classification System ◽

Subjective Evaluation ◽

Treatment Options ◽

Chewing Gum ◽

Common Complication ◽

Aesthetic Appearance ◽

Number Of Patients ◽

Obturator Prosthesis

The number of patients undergoing a surgical resection of the maxilla for oncological reasons is constantly increasing, the most common complication of which remains the communication between oral and nasal cavities. On the basis of data arising from the literature regarding the treatment options of maxillary oncological post-surgical defects, obturator prosthesis remains the most used worldwide. We studied 25 patients (with at least 1-year follow up) rehabilitated by obturator prosthesis after maxillary resection leading to oro-nasal communication, providing data on the objective/subjective evaluation of such rehabilitation and mastication performance measured by a two-color chewing gum test. The type of defect was classified according to the classification system proposed by Aramany. Among the patients in our study, 72% rated a higher score for either stability and retention than for aesthetic appearance, as confirmed by the Kapur score rated by clinicians. The two-color chewing gum test shows similar results as only one patient had insufficient chewing function. Interestingly, we found no correlation between the masticatory function and residual denture, confirming that the maxillary obturator remains a predictable solution in such patients regardless of the anatomical alterations following surgery.

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