Page 83 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

Maxillofacial prosthetic rehabilitation: a survey on the quality of life
INTRODUCTION
The face has a unique role in social and emotional expression and communication1,2. Maxillofacial defects, and their eventual reconstruction, may have important psychosocial implications in affected patients because social interactions and
emotional expression depend mainly upon the structural and functional integrity
of the head and neck region1,3-8. Maxillofacial prosthetic rehabilitation poses a valid
alternative when surgical reconstruction is not feasible or desirable5,9-17. Traditionally,
the retention of maxillofacial prostheses involved skin adhesives, anatomic undercuts,
and connection to spectacles or intraoral prostheses14,18.The use of adhesives, however,
has several disadvantages, including discoloration of the prosthesis, dermatologic
reactions, and poor performance during activity or perspiration9,12,19. The introduction
of craniofacial endosseous implants has improved the retention and stability of
prostheses with low surgical risks and few postsurgical complications15,18,20,21. A
successful prosthetic rehabilitation is one in which patients do not experience the
prosthesis as an extraneous object and which improves function and esthetics from 5 both a psychological and social point of view3,12,22. Another advantage of a prosthesis
is the possibility of tumor surveillance compared with surgical reconstruction, which covers up the surgical defect17 . Despite well-documented psychological benefits, maxillofacial prostheses are also subject to limitations, including material durability and color stability, These limitations necessitate frequent reprocessing of the prosthesis, which is time consuming for both patient and maxillofacial prosthodontist and costly for the patient15,18,23,24.
Patient satisfaction and the assessment of quality of life (QOL) is becoming increasingly important in the quality of care3,25. Treatment success and the level of reintegration is mainly determined by a subjective analysis of the patient23,25. Studies primarily focused on the subjective analysis of patients with facial prostheses in perceived QOL and using validated questionnaires are sparse, and their relevance is often limited by small numbers3,10,14,22,23,26. However, these studies have shown improvement in QOL after maxillofacial prosthetic treatment and the need for site- and treatment-specific questionnaires14,15,27.
The purpose of this clinical study was to assess patients’ opinions and satisfaction regarding facial prosthetic rehabilitation considering different parameters such as localization, chosen treatment modality, and specific type of retention. Furthermore,
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