Evaluating cosmetic results in maxillofacial prosthetics

Fifty-two patients with maxillofacial prosthetic restorations answered questionnaires to measure their feelings of well being. Their overall scores averaged 38.6%. Subsequently, three independent observers reported their evaluation for each patient, yielding a combined improvement score of 35.1%. The apparently low figures reflect the strict criteria used. Men patients showed a greater response than women patients both in subjective questionnaire scores and objective evaluation rating. Greater improvement was reported in younger patients, yet the objective evaluators found better success in the older age group. The original etiology of the maxillofacial defect, i.e., traumatic injury, congenital malformation, or surgical tumor excision was the most important factor in the evaluation. Questionnaire scores were similar in all categories. However, the objective evaluation, especially that of the sculptor, who judged color slides alone, was significantly higher in the injury group than in cancer patients. Apparently, the inner desperation of many cancer patients is apparent in their facial appearance even after complete prosthetic rehabilitation. Such patients deserve greater psychologic attention during their treatment. Prosthodontists should realize their tendency to be hypercritical of their own treatment results. Their constant striving for improvement in their treatment results leads them to belittle their achievements and to underestimate their success. Public opinion, as represented by the artists, is significantly more enthusiastic about maxillofacial prosthetic achievements.