Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction

Breeze, John; Rennie, Andrew; Morrison, A.; Dawson, David L.; Tipper, J.; Rehman, Khaleeq-Ur; Grew, N.; Snee, D.; Pigadas, N.

doi:10.1016/j.bjoms.2016.05.024

Cited by 51 publications

(44 citation statements)

References 23 publications

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“…This in turn can result in masticatory compromise, swallowing and speech impairment, nasal fluid regurgitation and aesthetic concerns. The management of the maxillectomy patient is a complex area where there is still much debate [2], but in the paediatric patient, there is virtually no literature detailing the most appropriate approach. The use of microvascular free-tissue transfer has gained in popularity over time in adults in order to effect a biological closure of the resulting oro-nasal communication, but in the paediatric patient with maxillary malignancy, the use of a prosthetic obturator is more commonly reported [3].…”

Section: Introductionmentioning

confidence: 99%

A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient

2017

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This report details the use of zygomatic oncology osseointegrated implants to support and retain a maxillary obturator in a 13-year-old male patient who underwent a right-sided hemi-maxillectomy (Brown Class 2b) (Brown and Shaw, Lancet Oncol 11:1001–8, 2010) for a myxoid spindle cell carcinoma. At the time of maxillary resection, two zygomatic oncology implants were inserted into the right zygomatic body and subsequently utilised to provide in-defect support and retention for a bar-retained maxillary acrylic obturator prosthesis, which restored the patient’s aesthetics and function to a very high level. Close follow-up over 2 years demonstrated ongoing excellent function and disease control with no deleterious effects on facial or dento-alveolar growth clinically. This is the first clinical report of its kind in the published literature detailing the use of a zygomatic implant-retained obturator in a paediatric patient.

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Section: Introductionmentioning

confidence: 99%

A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient

2017

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“…Uncertainty prevails with respect to the treatment outcome when the defects are closed surgically in comparison to its prosthetic rehabilitation, and it remains in the domain of the operator to decide the most appropriate means of the defect closure . Compelling evidence is lacking concerning the superiority of one treatment modality over the other, and no significant difference in the quality of life score was found when maxillectomy defects were treated either with an obturator or surgical reconstruction …”

Section: Discussionmentioning

confidence: 99%

“…[18][19][20][21][22] Compelling evidence is lacking concerning the superiority of one treatment modality over the other, and no significant difference in the quality of life score was found when maxillectomy defects were treated either with an obturator or surgical reconstruction. 15,[23][24][25] Irrespective of the final treatment options available for patients with bilateral maxillectomy, the most immediate matter to be addressed postsurgery is the maintenance of adequate nutrition in the interim phase. In addition, the literature is replete of concrete remedies for rehabilitating edentulous patients with bilateral maxillectomy during the interim period.…”

Section: Discussionmentioning

confidence: 99%

A custom made extraoral aid for retaining interim obturator in edentulous patients with bilateral maxillectomy: A report of four patients

Dhiman

Shastry

Bhandari

et al. 2019

Special Care in Dentistry

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It is a considerable challenge for a prosthodontist to rehabilitate and sustain the prosthesis in edentulous patients with bilateral maxillectomy. Compelling evidence is lacking with respect to the treatment outcome when the maxillary defects are closed surgically in comparison to their prosthetic rehabilitation. Four edentulous male patients, with bilateral maxillectomy defects were referred for prosthodontic intervention to meet their nutritional and speech issues. In the absence of intra oral supporting and retentive structures, it was decided to retain the obturator utilizing extraoral aid to address their functional needs. Customized headgear face‐bow retained obturators were adequately retentive and did serve its purpose well in all four patients. It also gave the liberty to alter retention and refine the prosthesis at will, provided access to the operated site for a quick evaluation of disease recurrence, and was economical to the patients. Considering the encouraging outcome experienced in this special category of individuals, it would be reasonable to believe that the headgear face‐bow assembly has an immense potential to function as a valuable, prudent, and a viable retentive aid for a non‐implant retained obturator in edentulous patients with extensive maxillary defect.

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“…In addition, treatment will be complex, with prolonged recovery time. [2,3] Making a choice between reconstruction with a free fl ap or rehabilitation with prosthetic obturator is not well defi ned, and it will depend on surgeon's expertise for a fi nal decision.…”

Section: Introductionmentioning

confidence: 99%

“…This is associated with less morbidity, low cost, can be modifi ed according to patient's needs and also allows for prosthetic reconstruction of lost structures, e.g., missing teeth and soft tissues. [3] Recent advancements in presurgical planning techniques have facilitated the use of composite free fl aps in anatomic reconstruction of bony infrastructure of maxilla. Various reconstructive options available have specifi c indications and advantages depending on anatomic features of ablative defect.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of quality of life of maxillectomy patients after prosthetic obturator rehabilitation

Gupta¹,

Luthra²,

Gupta³

2016

IDJAR

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Background: Surgical resection of orofacial neoplasms has a profound impact on the quality of life (QOL) for patients and their families. Maxillectomy defects are most commonly rehabilitated using obturator prosthesis. The purpose of this study was to investigate and evaluate the QOL of patients with maxillofacial defects after maxillectomy and prosthodontic therapy with obturator prosthesis. QOL is an important consideration that infl uences the living conditions of society. Material and Methods: About 16 out of 20 patients were included in the study. The QOL of these patients who underwent maxillectomy and prosthodontic therapy was assessed by applying a standard questionnaire, Obturator Functional Scale. Results: QOL after prosthetic obturator rehabilitation was assessed to be 59.9 ± 3.7% on average. QOL of obturator patients was not signifi cantly related to age (P = 0.9), and gender (P = 0.320). The extent of therapy was correlated positively with QOL. A signifi cantly better average rating was found in patient who underwent surgery (64.75 ± 1.2), followed by patients with surgery + radiotherapy (60.95 ± 2.02) and surgery + radiotherapy + chemotherapy (55 ± 2.36) with a P = 0.006. QOL was also signifi cantly related to educational status (P = 0.001) in contrast to other parameters like age and gender. Conclusion: Orofacial rehabilitation of patients with maxillofacial defects using obturator prosthesis is an appropriate treatment modality. To improve the situation of patients before and after maxillectomy, suffi cient information about treatment, adequate psychological care, and speech therapy should be provided. The signifi cance of sound functioning of obturator prosthesis for QOL was intensifi ed by the fi ndings of this study and confi rmed the results of similar studies.

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Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction

Cited by 51 publications

References 23 publications

A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient

A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient

A custom made extraoral aid for retaining interim obturator in edentulous patients with bilateral maxillectomy: A report of four patients

Evaluation of quality of life of maxillectomy patients after prosthetic obturator rehabilitation

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