Page 89 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

Maxillofacial prosthetic rehabilitation: a survey on the quality of life
clip system. Patients noted the loss of retentive force for bar-clip systems after a mean period of 14.4 months for nasal (n=5) and 10.5 months for auricular prostheses (n=6). None of the patients with orbital prostheses with bar-clip attachments reported loss of retention.
The results reveal that 46.1% of respondents reported minor soft tissue complications, such as slight redness of the peri-implant tissue. Seventy-three percent cleaned their prostheses and surrounding soft tissues daily. The remaining patients, of whom 73% wore auricular prostheses, cleaned their prosthesis only 2 or 3 times weekly. This difference was statistically significant (P=.01). Prostheses and skin were mainly cleaned with soap and water. However, 6 patients used disinfectant alcohol or stain-removing powder. No relation with earlier deterioration in color or material properties could be established. In addition, 12 patients described protecting their prostheses from environmental influences by using sunblock hats (n=4), eyeglasses (n=3), or an eye patch (n=1) or by covering the auricular prostheses with hair (n=4).
Statistically significantly more patients with nasal prostheses felt noticed by others in 5 their environment (P=.01). Fewer patients with auricular prostheses felt embarrassed
to show their defect in different social environments (P=.01). However, questions
concerning psychological and social aspects revealed no further statistically significant
differences for anatomic location or type of attachment. For type of prosthesis, an equal distribution was found for patients who gained in self-confidence (44%) (Table 2).
Finally, patients were asked to score their prostheses using the traditional Dutch grading scale, which is based on a numeric scale from 0 to 10, where 10 represents the highest general satisfaction rate. In addition, patients were asked for suggestions on improvement (Table 3).
Responses to open-ended questions corresponded with earlier findings of the questionnaire, with patients suggesting improvement of color stability, longevity, and a more pleasant feeling of the prosthetic material. Two patients who previously wore adhesive-retained prostheses noted hygiene as an advantage over bar-clip systems. Two other patients regarded adhesive-retained prostheses as more user friendly (1 nasal, 1 auricular prosthesis).
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