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Oral function after maxillectomy and reconstruction with an obturator.

A M Kreeft¹, M Krap, D Wismeijer

¹Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

International Journal of Oral and Maxillofacial Surgery

|September 4, 2012

Summary

Prosthetic obturation effectively reconstructs maxillectomy defects, offering mastication comparable to dentures. While defect size is less critical, radiotherapy negatively impacts outcomes, whereas preserving natural teeth improves function.

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Area of Science:

Oral and Maxillofacial Surgery
Reconstructive Surgery
Prosthodontics

Background:

Maxillectomy defects present reconstruction challenges with no consensus on optimal methods.
Prosthetic obturation and free flap transfer are primary reconstruction options.
Evaluating functional outcomes of prosthetic obturation is crucial for patient care.

Purpose of the Study:

To assess the functional outcomes of prosthetic obturation in maxillectomy patients.
To correlate outcomes with defect extent (Brown classification), dentition, and radiotherapy history.
To compare mastication, subjective complaints, and mouth opening after obturator reconstruction.

Main Methods:

Retrospective evaluation of 32 maxillectomy patients treated with prosthetic obturators.
Assessment of mastication (Mixing Ability Test), subjective oral/swallowing complaints, and maximal mouth opening.
Analysis of outcomes based on Brown maxillectomy classification, dentition status, and adjuvant radiotherapy.

Main Results:

Masticatory function (Mixing Ability Test scores) was comparable to edentulous individuals with full dentures.
Maximal mouth opening was significantly reduced in patients who received adjuvant radiotherapy (29.1mm vs 40.9mm).
Patients with residual dentition reported better mastication and subjective outcomes than edentate patients.

Conclusions:

Prosthetic obturation provides functional mastication for maxillectomy defects, similar to full dentures.
Adjuvant radiotherapy negatively impacts maximal mouth opening and subjective well-being.
Preserving natural dentition positively influences masticatory efficiency and patient-reported outcomes.