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Ghazy ES, Altonbary GY, Gebreel A, El-Daker MA, Hegazy SA. Evaluation and comparison of retention and patient satisfaction with milled polyetheretherketone versus metal maxillary obturators. J Prosthet Dent 2023:S0022-3913(23)00547-4. [PMID: 37838571 DOI: 10.1016/j.prosdent.2023.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 10/16/2023]
Abstract
STATEMENT OF PROBLEM Metal and polyetheretherketone (PEEK) have been used to rehabilitate maxillary defects with obturators, each having advantages and disadvantages. However, patient satisfaction with the obturator retention of each material is unclear. PURPOSE The purpose of this crossover clinical study was to compare retention and patient satisfaction between a milled cobalt chromium and a milled PEEK framework, each with a hollow bulb extension in polymethyl methacrylate (PMMA). MATERIAL AND METHODS Twenty patients who had received unilateral total maxillectomy and were treated in the prosthodontic department's maxillofacial clinic were enrolled in this crossover study. Each participant wore 2 different types of obturators for 6 months after insertion. Type CoCr received a milled cobalt chromium framework with a hollow bulb extension in PMMA first, and type Pk received a milled modified PEEK (BioHPP) framework with a hollow bulb extension in PMMA first. Patient satisfaction and retention force were measured immediately, at 3 months, and at 6 months after obturator insertions. The Fischer exact, chi-squared, and Monte Carlo tests were used to compare qualitative data. One-way ANOVA with the post hoc Tukey test was used for pair-wise comparison, and repeated measures ANOVA was used to compare before and after treatment at 3 and 6 months. RESULTS No significant difference was found between types in obturator insertion (P>.999), appearance of the upper lip (P>.999), mouth feeling (P=.301), pronunciation of words (P=.217), and talking in public (P=.589). A significant difference between types was found in speech after 6 months of obturator insertion (P=.016), swallowing liquids and food (P=.04), masticating foods (P=.007), appearance of clasps on anterior teeth (P=.002), satisfaction with appearance (P=.005), or avoidance of family events (P=.014) after 6 months of insertion. Types of obturators showed a statistically significant decrease in retention force with time (P<.001). CONCLUSIONS Although the retention force was less with PEEK than with Co-Cr clasps engaging the same undercuts, this retention force was adequate for retaining removable partial dentures. Co-Cr clasps can be considered better than PEEK clasps because they engage the same undercuts regarding loss of retention with time. Quality of life in patients after maxillary resection could be improved by using maxillary obturators. Type Pk was better than type CoCr in terms of esthetics, but the retention of the PEEK obturator after 6 months decreased because of wear, leading to difficulty swallowing food or liquids, mastication, and speech.
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Affiliation(s)
- Enas S Ghazy
- Assistant Lecturer, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Gilan Y Altonbary
- Associate Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ashraf Gebreel
- Associate Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Medhat A El-Daker
- Professor, Department of Microbiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Salah A Hegazy
- Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Alanezi A, Aljanahi M, Moharamzadeh K, Ghoneima A, Tawfik AR, Khamis AH, Abuzayeda M. Development and Comparison of Conventional and 3D-Printed Laboratory Models of Maxillary Defects. Dent J (Basel) 2023; 11:dj11050115. [PMID: 37232766 DOI: 10.3390/dj11050115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Recording accurate impressions from maxillary defects is a critical and challenging stage in the prosthetic rehabilitation of patients following maxillectomy surgery. The aim of this study was to develop and optimize conventional and 3D-printed laboratory models of maxillary defects and to compare conventional and digital impression techniques using these models. METHODS Six different types of maxillary defect models were fabricated. A central palatal defect model was used to compare conventional silicon impressions with digital intra-oral scanning in terms of dimensional accuracy and total time taken to record the defect and produce a laboratory analogue. RESULTS Digital workflow produced different results than the conventional technique in terms of defect size measurements which were statistically significant (p < 0.05). The time taken to record the arch and the defect using an intra-oral scanner was significantly less compared with the traditional impression method. However, there was no statistically significant difference between the two techniques in terms of the total time taken to fabricate a maxillary central defect model (p > 0.05). CONCLUSIONS The laboratory models of different maxillary defects developed in this study have the potential to be used to compare conventional and digital workflow in prosthetic treatment procedures.
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Affiliation(s)
- Ahmad Alanezi
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - May Aljanahi
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
- Dubai Dental Hospital (DDH), Dubai P.O. Box 505097, United Arab Emirates
| | - Keyvan Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
- School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK
| | - Ahmed Ghoneima
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - Abdel Rahman Tawfik
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - Moosa Abuzayeda
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
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Wang LM, Tian YY, Liu XM, Cao Y, Sui L, Mao C, Liu H, Ye JH, Zhou YS, Peng X, Ye HQ, Yan YB. Quality of life in patients with cancer-related Brown IIb maxillary defect: A comparison between conventional obturation rehabilitation and submental flap reconstruction. Oral Oncol 2022; 132:105980. [PMID: 35749804 DOI: 10.1016/j.oraloncology.2022.105980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/17/2022] [Accepted: 06/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this retrospective study was to compare the differences in quality of life (QOL) outcomes between the conventional obturator prostheses (COP) and the pedicled submental artery island flap (SAIF) in the reconstruction of Brown IIb maxillary defects. MATERIALS AND METHODS The QOL of 116 eligible patients who had a lapse ≥ 12 months after the cancer-related maxilla ablation was evaluated by the University of Washington quality of life scale (UW-QOL), Performance Status Scale for Head and Neck (PSS-HN), and Obturator Functioning Scale (OFS). RESULTS Patients in the SAIF group reported statistically and clinically significant higher overall QOL scores but lower chewing scores in the UW-QOL scale when compared with those in the COP group (P < 0.05). Clinically significantly higher scores were also observed in the recreation and anxiety domains in the UW-QOL scale for the SAIF group, but there was no statistical significances. The COP group reported more complaints about the nasal leakage when swallowing and the shape of the upper lip, and had a stronger willingness to avoid family or social events in the OFS (P < 0.05). CONCLUSIONS For patients with Brown IIb defects, SAIF reconstruction can achieve reduced nasal leakage when swallowing, improved upper-lip contour, increased social activity, and superior overall QOL than COP. The inferior chewing function in the SAIF group indicated the need for dental rehabilitation with a conventional denture or osseointegrated implants.
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Affiliation(s)
- Li-Mei Wang
- Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Yuan-Yuan Tian
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Xiao-Ming Liu
- Department of Prosthodontics, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Ye Cao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Lei Sui
- Department of Prosthodontics, Stomatological Hospital of Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Chi Mao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Hao Liu
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Jia-Hui Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Yong-Sheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Hong-Qiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Ying-Bin Yan
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China.
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Soares MEDC, Falci ALV, Freitas SFD, Mesquita ATM, Galo R. Reabilitação Oral com Prótese Obturadora em Comunicação Buconasal após Ocorrência de Carcinoma de Células Escamosas: Relato de Caso. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introdução: O tratamento de neoplasia maligna pode consistir em ampla excisão cirúrgica. Em alguns casos, em razão do tratamento agressivo na remoção do tumor, há grande comprometimento das estruturas intrabucais. Assim, próteses são utilizadas para a obturação da cavidade maxilar, possibilitando a reconstrução da região afetada, juntamente com a reabilitação oral. Relato do caso: Paciente de 53 anos de idade, sexo feminino, ex-tabagista e ex-etilista, apresentou diagnóstico de carcinoma de células escamosas na região de palato mole, sendo necessária cirurgia de ressecção transoral associada à radioterapia. Após aproximadamente um ano, a paciente retornou com nova lesão em palato, que novamente evidenciou carcinoma de células escamosas, sendo necessária nova cirurgia de ressecção transoral. Após dois anos, a paciente retornou ao Departamento de Odontologia a fim de receber o tratamento reabilitador, pois a prótese parcial removível superior era provisória, não substituía todos os dentes ausentes e não obtinha adaptação adequada à comunicação buconasal. Foi realizado tratamento reabilitador definitivo com prótese parcial removível superior e com prótese total no rebordo residual inferior. Conclusão: A necessidade do acompanhamento odontológico nos casos de ocorrência de carcinoma de células escamosas oral bem como a importância do tratamento reabilitador e suas técnicas contribuem para a autoestima e a qualidade de vida do paciente.
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Revoredo ECV, Gomes ADOC, Ximenes CRC, Oliveira KGSCD, Silva HJD, Leão JC. Oropharyngeal Geometry of Maxilectomized Patients Rehabilitated with Palatal Obturators in the Trans-surgical Period: Repercussions on the Voice. J Voice 2022:S0892-1997(22)00072-8. [PMID: 35396148 DOI: 10.1016/j.jvoice.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Patients undergoing maxillectomies may present alterations in the stomatognathic functions involved in oral communication. Rehabilitative treatment should favor the rescue of these functions, through surgical flaps, obturator prostheses or both. OBJECTIVES The present study aims to present the impact of the use of the palatal obturator on the oropharyngeal geometry and on the voice of patients undergoing maxillectomies, after adaptation to trans-surgical palatine obturators (TPO). METHODS Twelve patients treated at a Cancer Hospital, submitted to maxillectomy and rehabilitated during surgery were evaluated. The oropharyngeal geometry was measured by acoustic pharyngometry and the vocal parameters were evaluated through auditory-perceptual and acoustic analyses. The comparison between the results with and without TPO was analyzed using the Wilcoxon test and the correlation between oropharyngeal measurements and acoustic parameters using Spearman's correlation coefficient, all with a significance level of 5%. RESULTS There was a decrease in the following oropharyngeal measurements with the use of TPO: length of the pharyngeal cavity and vocal tract, volume of the oral cavity, pharyngeal and vocal tract and area of the oropharyngeal junction. There was no difference in the length of the oral cavity and in the glottic area between situations with and without TPO. In the vocal evaluation, changes in intelligibility and resonance were observed in the situation without TPO and, in only one case, mild hypernasality was detected in the situation with TPO. CONCLUSIONS It is concluded that the use of TPO brought the oropharyngeal measurements closer to normal values and provided an improvement in speech intelligibility and vocal resonance in maxilectomized individuals.
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Affiliation(s)
- Eliane Cristina Viana Revoredo
- Graduate Program in Dentistry at the Federal University of Pernambuco, Health Sciences Center, Recife, Pernambuco, Brazil
| | - Adriana de Oliveira Camargo Gomes
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Speech-Language Pathology and Audiology Department, Health Sciences Center, Recife, Pernambuco, Brazil.
| | - Coeli Regina Carneiro Ximenes
- Speech-Languague Pathology and Audiology Department at the Federal University of Pernambuco, Health Sciences Center, Recife, Pernambuco, Brazil
| | | | - Hilton Justino da Silva
- Graduate Program in Human Communication Health at the Federal University of Pernambuco, Speech-Language Pathology and Audiology Department, Health Sciences Center, Recife, Pernambuco, Brazil
| | - Jair Carneiro Leão
- Graduate Program in Dentistry at the Federal University of Pernambuco, Department of Clinical and Preventive Dentistry, Health Sciences Center, Recife, Pernambuco, Brazil
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Aladashi OQS, Shindy MI, Noaman SA, Alqutaibi AY, Refahee SM. Effect of submental flap reconstruction versus obturator rehabilitation after maxillectomy on quality of life: a randomized clinical trial. Int J Oral Maxillofac Surg 2020; 50:1156-1160. [PMID: 33386202 DOI: 10.1016/j.ijom.2020.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
The surgical removal of a maxillary tumour will result in an oronasal communication, which can negatively affect the patient's life and daily functions. Following maxillectomy, the defect can be treated with a prosthetic obturator or microvascular flap. However, the gold standard technique remains controversial. The aim of this study was to evaluate and compare quality of life (QoL) outcomes of submental island flap versus maxillary obturator reconstruction after partial maxillectomy. Sixty patients indicated for maxillectomy were allocated randomly to two equal-sized groups. Control group patients underwent reconstruction with a surgical obturator, while intervention group patients underwent submental island flap reconstruction. Patient QoL was evaluated at the 6-month follow-up using the University of Washington Quality of Life Questionnaire. Statistically significant differences in QoL were found between the two groups. Chewing (P = 0.034), swallowing (P < 0.001), speech (P = 0.009), taste (P = 0.04), mood (P = 0.01), and anxiety (P = 0.003) domains showed a statistically significant improvement in the submental group compared to the obturator group. However, the obturator group showed a greater improvement in appearance (P < 0.001). The masticatory function scores in the obturator group were significantly higher after obturator rehabilitation (P < 0.001). In conclusion, this study found that submental flap reconstruction provided better function and QoL than the obturator. This reconstruction was associated with less pain and better pronouncing of words, chewing, swallowing food, and psychosocial adjustment.
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Affiliation(s)
- O Q S Aladashi
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - M I Shindy
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - S A Noaman
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
| | - A Y Alqutaibi
- Department of Prosthodontics, College of Dentistry, Taibah University, Madinah, Saudi Arabia; Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen.
| | - S M Refahee
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
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Sudhan RH, Chander GN, Anitha KV. Finite element stress analysis of Aramany class I maxillectomy defect with single- and two-piece closed bulb obturators. Gerodontology 2020; 38:209-215. [PMID: 33345389 DOI: 10.1111/ger.12518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the stress on the surrounding structures of Aramany class I maxillectomy defect restored with different obturator prostheses. METHODS AND RESULTS Definitive three-dimensional (3D) finite element (FE) model of Aramany class I defect rehabilitated with single- and two-piece closed bulb obturator prostheses was constructed based on patient computed tomography (CT) using a software. Unilateral defect restored with tripodal design single-piece closed bulb obturator was used as FE model 1- and two-piece magnet retained closed bulb obturators as FE model 2. Finite element analysis (FEA) with three different load (150 N, 200 N and 250 N) applications was used to calculate the equivalent von Mises stress. A least stress value of 62.28 MPa was observed in two-piece closed bulb design with 150 N force, and highest stress value of 104.15 MPa was observed in single-piece obturator with application of 250 N force. CONCLUSION Minor difference in stress distribution pattern was observed between single-piece obturator and two-piece obturator, and stress value was comparatively lesser in two-piece than single-piece obturator. The stress pattern, distribution and numerical values increased with increase in magnitude of forces. More stress was observed on the lateral slopes of obturator closer to defect than in other areas of the obturator.
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Affiliation(s)
- Ram Harihara Sudhan
- Department of Prosthodontics, SRM Dental College & Hospitals, Chennai, India
| | - Gopi Naveen Chander
- Department of Prosthodontics, SRM Dental College & Hospitals, Chennai, India
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Negreiros WAD, Teixeira RR, Peixoto RF, Regis RR. The challenge of managing oral maxillofacial rehabilitation with quality and cost-benefit. J Prosthet Dent 2020; 127:508-514. [PMID: 33303193 DOI: 10.1016/j.prosdent.2020.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 10/22/2022]
Abstract
Although orofacial cancer leads to substantial functional, esthetic, and psychosocial deficits for patients, reconstructive plastic surgeries may not be indicated for large facial defects. The high costs of prosthetic oral maxillofacial rehabilitation may hamper such treatment, which commonly involves virtual planning, craniofacial implants, and computer-aided design and computer-aided manufactured prostheses. This report shows the treatment of 2 patients with large facial defects from surgical resection of cancerous tissue who were rehabilitated with implant-supported bar-clip overdentures and facial prostheses fabricated by using low-cost straightforward methods.
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Affiliation(s)
- Wagner Araujo de Negreiros
- Associate Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raiza Ricarte Teixeira
- Predoctoral student, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raniel Fernandes Peixoto
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
| | - Rômulo Rocha Regis
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
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Assessment of the Highest Stress Concentration Area Generated on the Mandibular Structure Using Meshless Finite Elements Analysis. Bioengineering (Basel) 2020; 7:bioengineering7040142. [PMID: 33171637 PMCID: PMC7712668 DOI: 10.3390/bioengineering7040142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/22/2020] [Accepted: 11/06/2020] [Indexed: 11/17/2022] Open
Abstract
Frequently, the oral cavity area can be affected by different diseases, so the patient needs to be submitted to surgery to remove a specific region of the mandibular. A complete or partial discontinuity of the mandibular bone can cause direct or indirect forces variations during the mastication. The dental prosthesis is an alternative to generate an aesthetic or functional solution for oral cavity lesions. However, they can be wrongly designed, or they can lose the adjustment during their useful life, deteriorating the patient’s condition. In this work, the influence of the fixation components position for a dental prosthesis will be studied based on the finite element method. By means, it is possible to determine the area of the highest stress concentration generated on the mandibular structure. The temporomandibular image obtained by computational tomography was used as a 3D graphic whole model because in the medical area the morphological factors are extremely important. Vertical loads of 50, 100, 150 and 200 N were applied in three different regions: in the whole buccal cavity, simultaneously in the left and right laterals and only in the right lateral, to determine the values of von Mises stress in the mandible. These results were compared between three finite element software packages (Ansys®, SolidWorks® and Inventor®) and a meshless software (SimSolid®). They showed similar behaviors in the highest mechanical stress concentration in the same regions. Regarding the stress values, the percentage error between each software package was less than 10%. The use of SimSolid® software (meshless) proved to be better at identifying the higher stress generated by the dental prosthesis in the facial skeleton, so its computational efficiency, due to its geometric complexity, was highlighted.
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A pilot study of masticatory function after maxillectomy comparing rehabilitation with an obturator prosthesis and reconstruction with a digitally planned, prefabricated, free, vascularized fibula flap. J Prosthet Dent 2020; 124:616-622. [DOI: 10.1016/j.prosdent.2019.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 12/29/2022]
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Villefort RF, Tribst JPM, Dal Piva AMDO, Borges AL, Binda NC, Ferreira CEDA, Bottino MA, von Zeidler SLV. Stress distribution on different bar materials in implant-retained palatal obturator. PLoS One 2020; 15:e0241589. [PMID: 33125441 PMCID: PMC7598468 DOI: 10.1371/journal.pone.0241589] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/16/2020] [Indexed: 11/19/2022] Open
Abstract
Implant-retained custom-milled framework enhances the stability of palatal obturator prostheses. Therefore, to evaluate the mechanical response of implant-retained obturator prostheses with bar-clip attachment and milled bars, in three different materials under two load incidences were simulated. A maxilla model which Type IIb maxillary defect received five external hexagon implants (4.1 x 10 mm). An implant-supported palatal obturator prosthesis was simulated in three different materials: polyetheretherketone (PEEK), titanium (Ti:90%, Al:6%, V:4%) and Co-Cr (Co:60.6%, Cr:31.5%, Mo:6%) alloys. The model was imported into the analysis software and divided into a mesh composed of nodes and tetrahedral elements. Each material was assumed isotropic, elastic and homogeneous and all contacts were considered ideal. The bone was fixed and the load was applied in two different regions for each material: at the palatal face (cingulum area) of the central incisors (100 N magnitude at 45°); and at the occlusal surface of the first left molar (150 N magnitude normal to the surface). The microstrain and von-Mises stress were selected as criteria for analysis. The posterior load showed a higher strain concentration in the posterior peri-implant tissue, near the load application side for cortical and cancellous bone, regardless the simulated material. The anterior load showed a lower strain concentration with reduced magnitude and more implants involving in the load dissipation. The stress peak was calculated during posterior loading, which 77.7 MPa in the prosthetic screws and 2,686 με microstrain in the cortical bone. For bone tissue and bar, the material stiffness was inversely proportional to the calculated microstrain and stress. However, for the prosthetic screws and implants the PEEK showed higher stress concentration than the other materials. PEEK showed a promising behavior for the bone tissue and for the integrity of the bar and bar-clip attachments. However, the stress concentration in the prosthetic screws may represent an increase in failure risk. The use of Co-Cr alloy can reduce the stress in the prosthetic screw; however, it increases the bone strain; while the Titanium showed an intermediate behavior.
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Affiliation(s)
- Regina Furbino Villefort
- Biotechnology Program, Federal University of Espírito Santo, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Espírito Santo, Brazil
| | - João Paulo Mendes Tribst
- Post-Graduate Program in Restorative Dentistry (Prosthodontic), Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp/SJC), São José dos Campos, SP, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Post-Graduate Program in Restorative Dentistry (Prosthodontic), Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp/SJC), São José dos Campos, SP, Brazil
| | - Alexandre Luiz Borges
- Post-Graduate Program in Restorative Dentistry (Prosthodontic), Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp/SJC), São José dos Campos, SP, Brazil
| | - Nívia Castro Binda
- Biotechnology Program, Federal University of Espírito Santo, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Espírito Santo, Brazil
| | | | - Marco Antonio Bottino
- Post-Graduate Program in Restorative Dentistry (Prosthodontic), Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp/SJC), São José dos Campos, SP, Brazil
| | - Sandra Lúcia Ventorim von Zeidler
- Biotechnology Program, Federal University of Espírito Santo, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Espírito Santo, Brazil
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Kalaignan SP, Ahmed SE. Oral Health-Related Quality of Life (OHRQoL) in Patients with Definitive Maxillary Obturator Prostheses: A Prospective Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820953961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To assess the impact of definitive maxillary obturator prostheses on oral health-related quality of life (OHRQol). Materials and Methods: A presented prospective study comprising 50 patients with maxillectomy defects was selected for the study. Patients with any active or persistent lesion in relation to the defect site, restrictive mouth opening along with poor general health were excluded from the study. All the patients were rehabilitated with definitive maxillary obturator prostheses, respectively. These patients were subjected for assessment of OHRQol and obturator prostheses functioning. These assessments were done using three scales OHIP-Edent-19, obturator functioning scale (OFS-15) and a novel scale—maxillofacial prosthesis performance scale (MFPPS). The assessment was done on all the patients after 2 weeks and 3 months of prosthesis function. The data were tabulated and analysed using paired sample t-test and the Wilcoxon signed rank test for paired groups and unpaired sample t-test for independent groups. Results: The scores of OHIP-Edent, OFS and MFPPS for definitive maxillary obturator prostheses after 2 weeks were 37.56, 30.48 and 20.50. The scores of OHIP-Edent, OFS and MFPPS for definitive maxillary obturator prostheses after 3 months were 30.30, 24.26 and 16.10, respectively. Conclusion: Mean differences of OHIP-Edent (7.260), OFS (6.220) and MFPPS (4.400) were observed after 2 weeks and 3 months of obturator prosthesis function. These findings show significant improvements of prosthesis in terms of functional, physical, psychological and social parameters after long-term follow-up (3 months).
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Affiliation(s)
- S. Parithimar Kalaignan
- Department of Prosthodontics, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation, Salem, Tamil Nadu, India
| | - Syed Ershad Ahmed
- Department of Prosthodontics, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation, Salem, Tamil Nadu, India
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Kurien A, Poundass M, Anirudhan S, Velliangattur TR, Yuvaraja BA, Masilamani A. Nasal prosthesis with magnetically secured intranasal framework for a patient with partial rhinectomy and intraoral defects: A case report. J Clin Transl Res 2020; 6:190-197. [PMID: 33501390 PMCID: PMC7821749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/18/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Partial rhinectomy is a challenge for most maxillofacial prosthodontists, as retention of the prosthesis is a major issue to overcome. The scenario becomes even more difficult when there is an intraoral defect. This article describes the fabrication of a removable silicone nasal prosthesis and removable PMMA intraoral obturator prosthesis to rehabilitate a patient following partial rhinectomy with associated loss of premaxilla. The retention of removable intraoral and extraoral prosthesis was achieved partially from anatomical undercuts and further enhanced by rare earth magnets placed between both prostheses. An acrylic framework was fabricated and placed inside to provide rigidity to the nasal part of the prosthesis. A customized method of making impressions using a modified syringe tube to mold the inner surface of the nasal defect is described. The obturator function scale (OFS) questionnaire was used to measure the patient's satisfaction with the obturator. After insertion of the prosthesis, there was an overall improvement in the OFS of the patient. RELEVANCE FOR PATIENTS This case report documents the rehabilitation of a patient following partial rhinectomy and associated loss of premaxilla with customized intraoral obturator prosthesis and a removable silicone nasal prosthesis. The successful outcome of this case shows that for people with similar orofacial defects, these prostheses are a good option to achieve acceptable esthetics, speech, and function.
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Affiliation(s)
- Anjana Kurien
- 1Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India,
Corresponding author: Anjana Kurien Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Megashyam Poundass
- 2Newgen Multispeciality Dental and Implant Care, Chennai, Tamil Nadu, India
| | - Subha Anirudhan
- 3Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | | | | | - Arun Masilamani
- 1Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
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Hemi-tongue Allograft Transplantation in Dogs. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2767. [PMID: 32440434 PMCID: PMC7209899 DOI: 10.1097/gox.0000000000002767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 02/19/2020] [Indexed: 12/16/2022]
Abstract
Background When complete recovery of tongue function following tumor excision is desired, reestablishment of the complex movements of the tongue is necessary. However, currently available methods for recovery of tongue function, such as flap surgery or prosthesis insertion, are inadequate. In the current study, we investigated the effects of transplantations of tongue allografts. Methods Hemi-tongue allotransplantation procedures were performed with 8 pairs of sex-blind and unrelated beagle dogs. In each donor, the right side of the tongue, including the lingual and hypoglossal nerves, extrinsic muscles of the tongue, mucous membrane of the oral floor, lingual artery, and vein were exposed. A vascularized transplantation method was used with manual anastomosis of the blood vessels and nerves. Results Survival of the grafted tongue was only noted in 1 dog that died 5 days after transplantation. We suspected that the death was due to nutritional deficiency or dehydration, rather than hyperacute rejection of the transplant or technical failure of the microsurgical anastomosis. The grafted tongue was partially connected to the side of the recipient tongue, and lymphocyte infiltration was observed in this dog. Conclusions Postoperative management is difficult in dogs. Even if tongue allograft including nerves and extrinsic muscles is performed, it seems to take a long time before the tongue recovers its functions. Furthermore, expansive tongue allograft was too invasive a treatment for animals. If we want to adapt this procedure to humans, the first trial in a human will be done without animal experiments, as was the case with face transplantations.
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A Novel Approach for Rehabilitation of a Subtotal Maxillectomy Patient with Immediately Loaded Basal Implant-Supported Prosthesis: 4 Years Follow-Up. Case Rep Dent 2020; 2020:9650164. [PMID: 32089903 PMCID: PMC7026704 DOI: 10.1155/2020/9650164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/22/2020] [Indexed: 11/17/2022] Open
Abstract
The prosthetic rehabilitation of maxillary defect can be achieved successfully by using an implant-supported prosthesis. The use of remote bony areas such as the zygomatic bone in cases of large defects provides an innovative substitute for free vascularized osteocutaneous flaps and the solution to flap failures. This report describes the rehabilitation of a 22-year-old female with a subtotal maxillectomy using an immediately loaded basal implant-supported prosthesis. Four basal cortical screw implants (BCS®) are inserted; 1 on the contralateral nasal floor, 2 implants in the pterygoid plates, and the last in the zygomatic bone using cone beam computed tomography scans. The prosthesis was constructed and cemented in 3 days. The surgical and prosthetic procedures were performed without any obstacles. After 4 years in function, the patient was highly satisfied with the treatment as it improved her mastication, speech, aesthetic and returned her self-esteem. To our knowledge, this is the first clinical report detailing the use of basal implant-retained obturator in a subtotal maxillectomy patient.
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Buurman DJM, Speksnijder CM, Engelen BHBT, Kessler P. Masticatory performance and oral health-related quality of life in edentulous maxillectomy patients: A cross-sectional study to compare implant-supported obturators and conventional obturators. Clin Oral Implants Res 2020; 31:405-416. [PMID: 31944417 PMCID: PMC7319476 DOI: 10.1111/clr.13577] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/05/2019] [Accepted: 01/08/2020] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to compare the masticatory performance and oral health-related quality of life (OHRQoL) of edentulous maxillectomy patients with and without implant-supported obturator prostheses. MATERIAL AND METHODS Nineteen edentulous maxillectomy patients with completed prosthetic obturator treatment in the upper jaw participated in this study. In nine patients, the obturator prosthesis was supported by implants in the remaining bone of the midface and/or skull base to improve retention. Masticatory performance was measured objectively by the mixing ability test (MAT) and subjectively by three OHRQoL questionnaires: (a) the Oral Health Impact Profile for EDENTulous people (OHIP-EDENT), (b) the Obturator Function Scale (OFS), and (c) the Dutch Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3-NL). The independent t test and the Mann-Whitney U test were used to test for differences in outcomes of patients with and without implant-retention of their obturator prostheses. RESULTS Patients with implant-supported obturator prostheses had significantly better masticatory and oral function, reported fewer chewing difficulties, and had less discomfort during food intake than did patients with a conventional obturator. CONCLUSION Supporting prosthetic obturators after maxillectomy with implants improve oral functioning, chewing, and eating comfort. This treatment modality is a viable technique to improve the functionality of prosthetic rehabilitation in patients who have undergone maxillectomy.
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Affiliation(s)
- Doke J M Buurman
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Caroline M Speksnijder
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Head and Neck Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht University, Utrecht, The Netherlands.,Julius Center Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Britt H B T Engelen
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Liu BY, Cao G, Dong Z, Chen W, Xu JK, Guo T. The application of 3D-printed titanium mesh in maxillary tumor patients undergoing total maxillectomy. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:125. [PMID: 31728639 DOI: 10.1007/s10856-019-6326-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the clinical outcomes of reconstruction of maxillary class III defect using 3D-printed titanium mesh. METHODS Twelve patients with maxillary class III defect from April 2015 to December 2016 were retrospectively studied. A 3D individualized maxillary stereo model based on mirror images of the unaffected maxilla was obtained to fabricate an anatomically adapted titanium mesh using computer-assisted design and manufacture. The individual titanium mesh was inserted into the maxillary class III defect after total maxillectomy. The incidence of postoperative complications was evaluated. The postoperative orbital volume and protrusion degree of eye were measured. RESULTS All patients were satisfied with their postoperative facial symmetry, without developing diplopia or endophthalmos. The postoperative orbital volumes were 26.41 ± 0.52 mL on the affected side and 26.55 ± 0.45 mL on the unaffected side. The postoperative protrusion degrees of affected and unaffected eyes were 16.21 ± 0.48 and 16.82 ± 0.79 mm, respectively. Titanium mesh exposure was observed in 2 patients and mild limitation of mouth opening was observed in 4 patients who underwent postoperative radiotherapy. CONCLUSION Reconstruction of maxillary class III defect with 3D-printed titanium mesh can achieve successful clinical outcomes, which recovered orbital volume and protrusion degree of eye. Twelve patients with maxillary class III defect were satisfied with their postoperative facial symmetry, without developing diplopia or endophthalmos. We investigated that reconstruction of maxillary class III defect with 3D-printed titanium mesh can achieve successful clinical outcomes.
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Affiliation(s)
- Bing-Yao Liu
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, PR China
| | - Gang Cao
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, PR China
| | - Zhen Dong
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, PR China
| | - Wei Chen
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, PR China
| | - Jin-Ke Xu
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, PR China
| | - Ting Guo
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China.
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Finite element analysis of displacement with single and two piece hollow bulb obturator prosthesis. Med J Armed Forces India 2019; 75:395-399. [PMID: 31719733 DOI: 10.1016/j.mjafi.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/23/2018] [Indexed: 11/24/2022] Open
Abstract
Background Rehabilitation of hemi-maxillectomy defects is difficult and challenging when there is displacement of obturator prosthesis. The literature lacks data on the displacement of different types of obturators. The intent of the study was to evaluate the differences in displacement between the single and two piece hollow bulb obturator prosthesis in Aramany Class I maxillectomy defect. Methods Finite element (FE) model of Aramany Class I maxillectomy defect restored with single and two piece closed bulb obturator was fabricated based on patient computed tomography (CT) scan. Finite element analysis (FEA) with three different load applications was done to measure the displacement of the obturator. Graphical and numerical values of displacement were obtained and the results were tabulated. Results The results were obtained as displacement colour images and the numerical displacement values. The displacement of two piece obturator was 4.779e-8, 6.372e-8, 7.965e-8 compared to single piece obturator 4.509e-8, 6.012e-8, and 7.5151e-8. There was marginal numerical increase in magnitude of displacement in two piece obturator compared to single piece obturator. Conclusion The study observed no significant difference in displacement between the obturator. The numerical difference in displacement is more in two piece obturator compared to the single piece obturator.
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Wang Y, Yang X, Gan R, Liu H, Wu G, Yu Q, Wang Z, Lu X, Jing J, Ma W, Quan Y, Sun Z, Fan L, Wang Y. Digital planning workflow for partial maxillectomy using an osteotomy template and immediate rehabilitation of maxillary Brown II defects with prosthesis. J Oral Rehabil 2019; 46:1133-1141. [PMID: 31260120 DOI: 10.1111/joor.12850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is increasing evidence of benefits for the rehabilitation of Brown II defects with prosthesis in surgery. However, the current literature is sparse for maxillary tumour resection using osteotomy templates. OBJECTIVES To assess the accuracy of maxillectomy using a custom fabricated osteotomy template and to evaluate the prosthesis for surgical accuracy, appearance and functioning (speech, swallowing and occlusal force). METHODS Ten patients with Brown II defects caused by tumour resection were treated with precise partial maxillectomy using an osteotomy template. The immediate rehabilitation of the Brown II defect was completed with a prefabricated prosthesis. The post-operative three-dimensional images and the pre-operative virtual images were superimposed, and average deviation and maximum deviation were calculated. Speech intelligibility, swallowing, appearance and University of Washington Quality of Life Questionnaire (UW-QoL) were examined at 1, 3 and 6 months after surgery. Occlusal force was examined post-operatively at 6 months. RESULTS The maximum deviation between the actual and virtual surgery was 5.12 ± 0.44 mm, with an average of 1.02 ± 0.17 mm. Speech intelligibility, swallowing and UW-QoL improved significantly (P < .05) after wearing the prosthesis. The recovery index of the occlusal force on the affected side was 20.19%-32.28%. The skewed degree of the mouth corner, the difference in the height of the left and right lips, the maximum deviation distance and the change area volume decreased significantly (P < .05). CONCLUSION The precise rehabilitation of maxillary Brown II defects can be achieved using a prosthesis fabricated with an osteotomy template. The prosthesis restored appearance and functional capabilities (such as speech and occlusal force).
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Affiliation(s)
- Yang Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xudong Yang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ronglin Gan
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huifen Liu
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guofeng Wu
- Department of Oral Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing Yu
- Department of Oral Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiyong Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaolin Lu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jianlong Jing
- Department of Oral Prosthodontics Technician, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenjie Ma
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yi Quan
- Shanghai UEG Medical Device Co., Ltd, Shanghai, China
| | - Ziang Sun
- Shanghai UEG Medical Device Co., Ltd, Shanghai, China
| | - Lei Fan
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuxin Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Qin SH, Li XM, Li WL. [Systematic retrospective study of oral cancer-related quality of life scale]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:410-420. [PMID: 30182570 PMCID: PMC7048259 DOI: 10.7518/hxkq.2018.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 06/09/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The quality of life (QOL) related to oral cancer has recently become a focus of clinical studies. This study aims to systematically review the current research situation of QOL of local and foreign oral cancer patients and explore the existing related problems and future research directions to provide references and solutions. METHODS Through relevant key words, PubMed, Wiley InterScience, Science Direct, CNKI, and Wanfang databases were first searched. The related target literature from 2000 to 2017 were screened. Finally, the frequency of oral cancer related to QOL scale used in literature was calculated, and the related scales were briefly introduced. RESULTS From the target literature, 218 English target literature, 55 Chinese target literature, 24 English scales, and 12 Chinese scales were selected. The most widely used scales for assessing the QOL of patients with oral cancer were as follows: University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Head and Neck 35 (EORTC QLQ-C30/H&N35), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), and Oral Health Impact Profile (OHIP). CONCLUSIONS The QOL related to oral cancer was well underway, and the study of geographical distribution was widespread. However, the work on self-developed scale remains inadequate. UW-QOL, EORTC QLQ-C30/H&N35, and FACT-H&N can be utilized as the preferred scales for evaluating the QOL of oral cancer patients. A specific disease-related function scale can also be selected according to specific research objectives.
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Affiliation(s)
- Shuai-Hua Qin
- Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xin-Ming Li
- Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Wen-Lu Li
- Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Abstract
PURPOSE Patients with maxillofacial defects secondary to the removal of benign and malignant pathologies of midface have a profound impact on quality of life. The aim of this study was to collect and analyze the data pertaining to 4 designs of obturator by assessment of the patient with obturator functioning scale (OFS) MATERIALS AND METHODS:: This retrospective analysis included all the patients who underwent prosthetic rehabilitation of maxillary defects using 4 different types (conventional, cast partial, hollow bulb, and magnet retained) of obturators from 2009 to 2016 with minimum 1 year of follow up. Demographics, number, size, location, type of pathology, postmorbid dentition, and the treatment rendered were recorded. Obturator functioning scale was used to subjectively assess the patient satisfaction. RESULTS The mean score on OFS was 5.67 (standard deviation: 1.8). There was a fair and statistical improvement in chewing/eating, speech clarity in public/on phone, swallowing of foods and liquids, pronunciation of words, and social interaction (P < 0.05). The outcome was best in magnet retained followed by cast partial group. The least outcome was in conventional obturator group. CONCLUSION Obturators of different designs do play an important role in rehabilitation of maxillary defects with a satisfactory outcome.
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