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Journal of Prosthetic Dentistry

Maxillofacial prosthetic rehabilitation: A survey on the quality of life

      Abstract

      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.

      Purpose

      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.

      Results

      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.

      Conclusions

      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.
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      References

        • Millsopp L.
        • Brandom L.
        • Humphris G.
        • Lowe D.
        • Stat C.
        • Rogers S.
        Facial appearance after operations for oral and oropharyngeal cancer: a comparison of casenotes and patient-completed questionnaire.
        Br J Oral Maxillofac Surg. 2006; 44: 358-363
        • Hooper S.M.
        • Westcott T.
        • Evans P.L.
        • Bocca A.P.
        • Jagger D.C.
        Implant-supported facial prostheses provided by a maxillofacial unit in a U.K. regional hospital: longevity and patient opinions.
        J Prosthodont. 2005; 14: 32-38
        • Atay A.
        • Peker K.
        • Gunay Y.
        • Ebrinc S.
        • Karayazgan B.
        • Uysal O.
        Assessment of health-related quality of life in Turkish patients with facial prostheses.
        Health Qual Life Outcomes. 2013; 11: 11
        • Goiato M.C.
        • Pesqueira A.A.
        • Ramos da Silva C.
        • Gennari Filho H.
        • Micheline Dos Santos D.
        Patient satisfaction with maxillofacial prosthesis. Literature review.
        J Plast Reconstr Aesthet Surg. 2009; 62: 175-180
        • Bonanno A.
        • Esmaeli B.
        • Fingeret M.C.
        • Nelson D.V.
        • Weber R.S.
        Social challenges of cancer patients with orbitofacial disfigurement.
        Ophthal Plast Reconstr Surg. 2010; 26: 18-22
        • Callahan C.
        Facial disfigurement and sense of self in head and neck cancer.
        Soc Work Health Care. 2004; 40: 73-87
        • Chang T.L.
        • Garrett N.
        • Roumanas E.
        • Beumer 3rd, J.
        Treatment satisfaction with facial prostheses.
        J Prosthet Dent. 2005; 94: 275-280
        • Katz M.R.
        • Irish J.C.
        • Devins G.M.
        • Rodin G.M.
        • Gullane P.J.
        Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender and social support.
        Head Neck. 2003; 25: 103-112
        • Markt J.C.
        • Lemon J.C.
        Extraoral maxillofacial prosthetic rehabilitation at the M. D. Anderson Cancer Center: a survey of patient attitudes and opinions.
        J Prosthet Dent. 2001; 85: 608-613
        • Wondergem M.
        • Lieben G.
        • Bouman S.
        • van den Brekel M.W.
        • Lohuis P.J.
        Patients’ satisfaction with facial prostheses.
        Br J Oral MaxillofacSurg. 2016; 54: 394-399
        • De Leeuw J.R.
        • De Graeff A.
        • Ros W.J.
        • Hordijk G.J.
        • Blijham G.H.
        • Winnubst J.A.
        Negative and positive influences of social support on depression in patients with head and neck cancer: a prospective study.
        Psychooncology. 2000; 9: 20-28
        • Vickery L.E.
        • Latchford G.
        • Hewison J.
        • Bellew M.
        • Feber T.
        The impact of head and neck cancer and facial disfigurement on the quality of life of patients and their partners.
        Head Neck. 2003; 25: 289-296
        • Katz M.R.
        • Irish J.C.
        • Devins G.M.
        • Rodin G.M.
        • Gullane P.J.
        Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients.
        Head Neck. 2000; 22: 132-141
        • Smolarz-Wojnowska A.
        • Raithel F.
        • Gellrich N.C.
        • Klein C.
        Quality of implant anchored craniofacial and intraoral prostheses: patient's evaluation.
        J Craniofac Surg. 2014; 25: e202-e207
        • Arcuri M.R.
        • LaVelle W.E.
        • Fyler A.
        • Funk G.
        Effects of implant anchorage on midface prostheses.
        J Prosthet Dent. 1997; 78: 496-500
        • dos Santos D.M.
        • Goiato M.C.
        • Sinhoreti M.A.
        • Fernandes A.U.
        • Ribeiro Pdo P.
        • Dekon S.F.
        Color stability of polymers for facial prosthesis.
        J Craniofac Surg. 2010; 21: 54-58
        • dos Santos D.M.
        • Goiato M.C.
        • Pesqueira A.A.
        • Bannwart L.C.
        • Rezende M.C.
        • Magro-Filho O.
        • et al.
        Prosthesis auricular with osseointegrated implants and quality of life.
        J Craniofac Surg. 2010; 21: 94-96
        • Goiato M.C.
        • Delben J.A.
        • Monteiro D.R.
        • dos Santos D.M.
        Retention systems to implant-supported craniofacial prostheses.
        J Craniofac Surg. 2009; 20: 889-891
        • Nemli S.K.
        • Aydin C.
        • Yilmaz H.
        • Bal B.T.
        • Arici Y.K.
        Quality of life of patients with implant-retained maxillofacial prostheses: a prospective and retrospective study.
        J Prosthet Dent. 2013; 109: 44-52
        • Karakoca S.
        • Aydin C.
        • Yilmaz H.
        • Bal B.T.
        Retrospective study of treatment outcomes with implant-retained extraoral prostheses: survival rates and prosthetic complications.
        J Prosthet Dent. 2010; 103: 118-126
        • Leonardi A.
        • Buonaccorsi S.
        • Pellacchia V.
        • Moricca L.M.
        • Indrizzi E.
        • Fini G.
        Maxillofacial prosthetic rehabilitation using extraoral implants.
        J Craniofac Surg. 2008; 19: 398-405
        • Schoen P.J.
        • Raghoebar G.M.
        • van Oort R.P.
        • Reintsema H.
        • van der Laan B.F.
        • Burlage F.R.
        • et al.
        Treatment outcome of bone-anchored craniofacial prostheses after tumor surgery.
        Cancer. 2001; 92: 3045-3050
        • Curi M.M.
        • Oliveira M.F.
        • Molina G.
        • Cardoso C.L.
        • Oliveira Lde G.
        • Branemark P.I.
        • et al.
        Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation.
        J Oral Maxillofac Surg. 2012; 70: 1551-1557
        • Visser A.
        • Raghoebar G.M.
        • van Oort R.P.
        • Vissink A.
        Fate of implant-retained craniofacial prostheses: life span and aftercare.
        Int J Oral Maxillofac Implants. 2008; 23: 89-98
        • Abu-Serriah M.M.
        • McGowan D.A.
        • Moos K.F.
        • Bagg J.
        Outcome of extra-oral craniofacial endosseous implants.
        Br J Oral Maxillofac Surg. 2001; 39: 269-275
        • Lemon J.C.
        • Chambers M.S.
        • Jacobsen M.L.
        • Powers J.M.
        Color stability of facial prostheses.
        J Prosthet Dent. 1995; 74: 613-618
        • Montgomery P.C.
        • Kiat-Amnuay S.
        Survey of currently used materials for fabrication of extraoral maxillofacial prostheses in North America, Europe, Asia, and Australia.
        J Prosthodont. 2010; 19: 482-490