Longevity of terminal abutment teeth retaining maxillary obturator prostheses

To evaluate the longevity of terminal abutment teeth retaining maxillary obturator prostheses.

This was a retrospective study of patients who underwent maxillectomy followed by delivery of definitive obturator prostheses between 1994 and 2020. Details on patient demographics, primary tumor, and radiation therapy were collected. The tooth closest to the defect was identified as the terminal abutment, and information such as tooth type, condition of tooth at the time of maxillectomy, Aramany classification, and cause of abutment loss were noted from the dental charts. Survival time of the terminal abutment tooth was calculated from the date of maxillectomy to the last dental follow-up visit or the date of abutment loss. Univariate analyses were performed to test for the association between survival time and each of the four covariates.

In the 26-year study period, 148 teeth in 130 patients met the inclusion criteria. Ninety-eight (66.2%) terminal abutment teeth survived, and 50 (33.8%) were lost. Squamous cell carcinoma was the leading tumor diagnosis (51%). Aramany Class II was the most predominant arch configuration (51%). The majority of the terminal abutment teeth were maxillary incisors (43%). The chief cause of terminal abutment loss was bone loss and mobility (46%). The 10-year survival probability was 65%. Radiation therapy did not statistically contribute to terminal abutment loss. Terminal abutment teeth with dental treatment showed higher failure than those without any prior treatment or dental disease.

Clinicians must be aware of the various factors affecting the survival of terminal abutment teeth which can ultimately affect the success of the maxillary obturator prostheses.