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The reconstruction of post-ablative maxillary defects is controversial. It is accepted that quality of life indicators are poorer for maxillary reconstruction compared with mandibular reconstruction. One factor highlighted is that of post-treatment trismus. Rates of trismus are reviewed comparing free tissue transfer to that of prosthetic obturation. A retrospective review was undertaken comparing rates of trismus at twelve months post-surgery between free tissue transfer and prosthetic obturation. A total of 85 patients were identified who met the inclusion criteria. Both reconstruction techniques were significant for developing trismus, with a higher rate in the free flap reconstruction cohort than the prosthetic obturation cohort by a factor of 2.51. Modern reconstructive head and neck surgery has moved away from 'filling a hole' to a more bespoke, patient-specific reconstruction. The evidence presented here should allow the reconstructive surgeon to better discuss outcomes with patients when considering surgical options for Class II maxillary defects.
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http://dx.doi.org/10.1016/j.bjoms.2024.09.005 | DOI Listing |
Cureus
July 2025
Department of Prosthodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, IND.
Craniofacial rehabilitation demands a multidisciplinary approach where prosthodontists play a pivotal yet often underutilized role in the continuum of care. Traditionally, prosthetic rehabilitation is considered a postsurgical step, leading to delays in functional restoration and compromised outcomes. This editorial emphasizes the need to redefine prosthodontics as an integral component of craniofacial surgical planning, from the operating room to the dental chair.
View Article and Find Full Text PDFJ Craniofac Surg
August 2025
Department of Clinical, Pathology and Dental Surgery, School of Dentistry, Federal University of Minas Gerais (FAO-UFMG).
Cleft lip and palate require reparative surgeries, and even after these procedures, many patients continue to experience speech difficulties, especially due to velopharyngeal dysfunction, which may necessitate the use of prosthetic devices to complement rehabilitation. The aim of this case report is to describe the resolution of a case of velopharyngeal dysfunction following multiple corrective surgeries for a complete bilateral cleft lip and palate. A 36-year-old female patient sought care from the extension project "Prosthetic rehabilitation of patients with tissue loss in the head and neck region" at the School of Dentistry of UFMG, with the main complaint of phonetic difficulty.
View Article and Find Full Text PDFCureus
July 2025
Department of Prosthodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, IND.
Head and neck cancers often require aggressive treatments such as surgery, radiotherapy, and chemotherapy, which, although effective in tumor control, frequently lead to debilitating anatomical and functional impairments. Speech disturbances, impaired mastication, and facial disfigurement severely affect patients' quality of life. Despite its critical role in restoring these vital functions, prosthodontic rehabilitation remains underutilized, especially in low- and middle-income countries.
View Article and Find Full Text PDFSupport Care Cancer
July 2025
Department of Dental Technology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Sh
Prosthetic rehabilitation remains the predominant strategy for the reconstruction of maxillary defects. However, conventional impression techniques are often cumbersome and uncomfortable for patients, while the limited precision of medical-grade silicone 3D processing presents additional challenges to achieving optimal prosthetic outcomes. This technical note introduces a novel digital workflow for the design and fabrication of split negative molds for obturator prostheses in post-maxillectomy patients, aiming to address both the discomfort associated with traditional impression-taking and the inaccuracies commonly encountered in prosthesis manufacturing.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
August 2025
University of Eastern Piedmont, Vercelli, Italy.
Introduction: Obturator prostheses and removable prostheses still represent a valid option in head and neck cancer patients. The aim of the present article is to briefly review the current literature about the use of a digital workflow in the intraoral prosthetic rehabilitation of head and neck cancer patients.
Methods: The review included articles in English published from January 2010 to February 2023.