[Maxillo-facial prostheses: an issue in public health]

Acquired or congenital loss of structure can cause facial deformity. This can destroy identity and lead to certain forms of exclusion. Surgical and sometimes prosthetic reconstruction is required. The Maxillofacial Prosthesis (P.M.F) can be defined as the art and science of artificial reconstruction of facial bones. There is a continual increase in patient demand for this type of prosthesis with the development of new materials, methodologies and techniques.

In Toulouse, the Rangueil University Hospital houses a maxillofacial prosthesis consultation facility linked to the Odontology Service. An exhaustive descriptive study carried out retrospectively on the basis of the files of all patients examined between July 1996 and July 2002 will provide us with an understanding of patient characteristics and also enable us to quantify the level of satisfaction of requirements for rehabilitation of these losses of maxillofacial structure.

215 patient files were processed between July 1996 and July 2002. Separating the patients by sex shows a male prevalence of 66%. An analysis of variations between male and female patients for different aetiologies shows that tumour pathologies are more common in men and that this distinction is all the more marked as regards traumatic facial injuries and in particular suicide attempts. In total, 401 maxillofacial prostheses were carried out, including 116 facial epitheses (new prostheses or renewal of prosthesis).

Loss of facial structure, whatever its aetiology constitutes a real public health issue. The maxillofacial prosthesis will allow cancer monitoring of the site while at the same time offering out patient treatment. Above and beyond its crafted or empirical aspect, it should find its place in medicine thanks to the overall scope of the rehabilitation that it can offer from both an aesthetic point of view but also a the psychological one, but above all from a functional perspective.