Statement of problem
Maxillofacial prostheses, especially those supported by endosseous implants, are regarded
as a viable, secure treatment for the reconstruction of facial defects to restore
quality of life. The long-term quality of life of patients treated with facial prostheses
with different retentive systems is unclear.
The purpose of this clinical study was to assess the long-term quality of life of
patients treated with facial prostheses with different retentive systems over a 14-year
period at a Dutch oral and maxillofacial surgery unit.
Material and methods
A total of 66 patients with facial prostheses were inventoried and categorized based
on anatomic location and type of retention. A 62-item questionnaire was designed to
survey the daily prosthetic use, care, quality, durability, longevity, and reliability
of retention. Furthermore, issues relating to general satisfaction, self-image, and
socialization frequency were addressed.
Completed validated questionnaires were returned by 52 patients. Of the prosthetic
replacements, 23% (n=12) were orbital, 33% (n=17) nasal, and 44% (n=23) auricular
prostheses. The survey showed that a prosthetic reconstruction led to high satisfaction
scores with regard to wearing comfort, anatomic fit, color, and anatomic form. A significant
difference was shown for implant-retained facial prostheses, which provided enhanced
retention and increased ease of placement and removal (Fisher exact test P=.01 and P=.04). Patients with nasal prostheses were less satisfied with the junction of their
prostheses to the surrounding soft tissue and more aware of others noticing their
prosthetic rehabilitation. Patients with auricular defects were less embarrassed (P=.01) by their prostheses. Although auricular prostheses were less frequently cleaned
(P=.01), no significant difference was found in minor soft tissue complications between
different anatomic locations and the various retentive systems.
Implant-retained prostheses have advantages over adhesive-retained prostheses in terms
of ease of handling. However, improvements in prosthetic material properties, including
color stability and durability, are needed to increase the longevity of facial prostheses.