A pilot study of masticatory function after maxillectomy comparing rehabilitation with an obturator prosthesis and reconstruction with a digitally planned, prefabricated, free, vascularized fibula flap

Groot, Reilly J. de; Rieger, Jana; Rosenberg, Antoine J.W.P.; Merkx, M.A.W.; Speksnijder, Caroline M.

doi:10.1016/j.prosdent.2019.06.005

Cited by 15 publications

(28 citation statements)

References 36 publications

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“…Our surgically reconstructed group has previously been compared with patients with an conventional obturator, most of them without implants 12,37‐39 . In contrast to our obturator group, the obturator group of this previous cross‐sectional study had a significant lower mean MAI index (27.3 ± 0.5) which represents very limited masticatory performance.…”

Section: Discussionmentioning

confidence: 82%

“…A recently published systematic review describes a risk of selection bias and heterogeneous measurements for studies comparing masticatory efficiency 7 . Additionally, the different methods of measuring masticatory performance: mixing ability test, colour changing chewing gum, and sieving method used in maxillectomy patients 11‐13,21,25,29,33‐36 complicate the comparison of the study results.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical reconstruction group consisted of patients treated at the University of Alberta Hospital and rehabilitated at the Institute for Reconstructive Sciences in Medicine (iRSM). Patients treated for benign tumours, or malignant tumours with a curative intent were included 12 . Eligible tumour locations were upper alveolar process, tuber maxillae, palate and maxillary sinus.…”

Section: Methodsmentioning

confidence: 99%

“…Patients at the University of Alberta have been included as part of the HREBA.CC‐17‐0167 study, 12 and at Maastricht UMC + as part of the METC.15‐4‐123 study 21 . For both studies medical‐ethical approval was given.…”

Section: Methodsmentioning

confidence: 99%

“…Regardless of the rehabilitation route, defects that comprise a significant part of the dental alveolus, require dental rehabilitation to allow for optimal mastication and dental appearance 3 . Regarding mastication, comparative studies between surgical reconstruction and obturation seem to favour surgical reconstruction, especially in patients with larger maxillary defects 11‐13 . At the same time, QoL‐research shows equivalent results for both options 14‐17 .…”

Section: Introductionmentioning

confidence: 99%

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Mastication in maxillectomy patients: A comparison between reconstructed maxillae and implant supported obturators: A cross‐sectional study

Buurman

Speksnijder

Groot

et al. 2020

J of Oral Rehabilitation

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Objective The aim of this study was to compare masticatory performance and patient reported eating ability of maxillectomy patients with implant‐supported obturators and patients with surgically reconstructed maxillae. Methods This cross‐sectional study was conducted at the University of Alberta, Edmonton, Canada and at Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. Eleven surgically reconstructed maxillectomy patients have been included at University of Alberta and nine implant‐supported obturator patients at MUMC+. The mixing ability test (MAT) was used to measure masticatory performance. In addition, the oral health related quality of life (OHRQoL) was measured with shortened versions of the oral health impact profile (OHIP) questionnaire. Values of the implant‐supported obturator group versus the surgical reconstruction group were compared with independent t‐tests in case of normal distribution, otherwise the Mann‐Whitney U test was applied. Results Patients with reconstructed maxillae and patients with implant‐supported obturator prostheses had similar mean mixing ability indices (18.20 ± 2.38 resp. 18.66 ± 1.37; P = .614). The seven OHRQoL questions also showed no differences in masticatory ability between the two groups. Conclusion With caution, the results of this study seem to confirm earlier results that implant‐supported obturation is a good alternative to surgical reconstruction for all Class II maxillary defects. With both techniques, the masticatory performance is sufficiently restored, with careful planning being highly desirable.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mastication in maxillectomy patients: A comparison between reconstructed maxillae and implant supported obturators: A cross‐sectional study

Buurman

Speksnijder

Groot

et al. 2020

J of Oral Rehabilitation

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Microvascular Free Flap Outcomes in Maxillectomy Defects from Invasive Fungal Sinusitis

Rao,

Knott,

Sweeny

et al. 2023

The Laryngoscope

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ObjectivesMicrovascular free tissue transfer is routinely used for reconstructing midface defects in patients with malignancy, however, studies regarding reconstructive outcomes in invasive fungal sinusitis (IFS) are lacking. We aim to describe outcomes of free flap reconstruction for IFS defects, determine the optimal time to perform reconstruction, and if anti‐fungal medications or other risk factors of an immunocompromised patient population affect reconstructive outcomes.MethodsRetrospective review of reconstruction for IFS (2010–2022). Age, BMI, hemoglobin A1c, number of surgical debridements, and interval from the last debridement to reconstruction were compared between patients with delayed wound healing versus those without. Predictor variables for delayed wound healing and the effect of time on free flap reconstruction were analyzed.ResultsTwenty‐seven patients underwent free flap reconstruction for IFS. Three patients were immunocompromised from leukemia and 21 had diabetes mellitus (DM). Patients underwent an average of four surgical debridements for treatment of IFS. The interval from the last IFS debridement to flap reconstruction was 5.58 months (±5.5). Seven flaps (25.9%) had delayed wound healing. A shorter interval of less than 2 months between the last debridement for IFS and reconstructive free flap procedure was associated with delayed wound healing (Fisher Exact Test p = 0.0062). Other factors including DM, BMI, HgA1c, and bone reconstruction were not associated with delayed wound healing.ConclusionPatients with maxillectomy defects from IFS can undergo microvascular‐free flap reconstruction with good outcomes while on anti‐fungal medication. Early reconstruction in the first 2 months after the last IFS debridement is associated with delayed wound healing.Level of EvidenceIV Laryngoscope, 2023

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A fully digital workflow for the design and manufacture of a class of metal orthodontic appliances

Yu,

Li,

et al. 2024

Heliyon

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A pilot study of masticatory function after maxillectomy comparing rehabilitation with an obturator prosthesis and reconstruction with a digitally planned, prefabricated, free, vascularized fibula flap

Cited by 15 publications

References 36 publications

Mastication in maxillectomy patients: A comparison between reconstructed maxillae and implant supported obturators: A cross‐sectional study

Mastication in maxillectomy patients: A comparison between reconstructed maxillae and implant supported obturators: A cross‐sectional study

Microvascular Free Flap Outcomes in Maxillectomy Defects from Invasive Fungal Sinusitis

A fully digital workflow for the design and manufacture of a class of metal orthodontic appliances

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