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Rehabilitating a Complex Mid-facial Defect With an Interim, Magnet-Retained, Two-Piece Acrylic Prosthesis: A Case

Suja Joseph1, Nazia Rasheed2, Angel M Joseph3

  • 1Prosthodontics, Travancore Dental College, Kollam, IND.

Cureus
|April 18, 2025
PubMed
Summary
This summary is machine-generated.

A custom two-piece prosthesis effectively rehabilitated a patient with a complex mid-facial defect after cancer surgery. This solution improved appearance, swallowing, and reduced regurgitation, offering a non-invasive option when surgery is not feasible.

Keywords:
carcinomafacial injuriesmagneticsmaxillofacial prosthesismidfacial defectsoral neoplasms

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Area of Science:

  • Prosthodontics
  • Oral and Maxillofacial Surgery
  • Oncology Rehabilitation

Background:

  • Mid-facial defects present complex challenges for prosthetic rehabilitation, often involving intraoral and external components.
  • Recurrent adenoid cystic carcinoma necessitates extensive surgical resection, potentially leading to significant orofacial defects.
  • Surgical reconstruction may be contraindicated due to patient factors or defect complexity.

Observation:

  • An 80-year-old male patient presented with a complex left-sided mid-facial defect involving the maxilla, infratemporal fossa, and lateral nasal wall, with intraoral-external communication.
  • The patient experienced challenges with facial appearance, mastication, speech, swallowing, nasal regurgitation, and oral fluid leakage.
  • Complications included fibrotic healing, trismus, and mandibular deviation, rendering surgical reconstruction unsuitable.

Findings:

  • An interim, magnet-retained, two-piece acrylic prosthesis was fabricated, comprising a palatal obturator and a cheek prosthesis.
  • The cheek prosthesis improved facial aesthetics, while the palatal obturator sealed the intraoral defect, enhancing swallowing and preventing regurgitation/leakage.
  • While mastication and speech were impacted, the prosthesis offered improved retention, stability, and support, enabling a semi-solid diet and slightly clearer speech.

Implications:

  • This non-invasive, cost-effective prosthetic solution successfully addressed functional and aesthetic deficits in a patient unsuitable for further surgery.
  • Customized prosthetics can significantly improve the quality of life for patients with extensive orofacial defects.
  • The magnetic retention and anatomical support provided a stable and retentive outcome for the complex defect rehabilitation.