Skip to main content

Advertisement

SpringerLink
Log in

Prosthetic versus surgical rehabilitation in patients with maxillary defect regarding the quality of life: systematic review

  • Review Article
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Purpose

To assess the ability of prosthetic rehabilitation versus surgical rehabilitation in improving the QOL for patients with maxillary defects.

Material and methods

A systematic search of PubMed, Scopus data base, Cochrane database, Ovid database, and Latin America & Caribbean database for articles published before September 2017 was performed by two independent reviewers. A manual search of articles published from January 2000 to September 2017 was also conducted. Only English studies were included which evaluate the QoL in patients with head and neck cancers. Any confusion between the two independent reviewers was resolved by means of a moderated discussion between the reviewers.

Results

Five studies fulfilled the inclusion criteria for this study. Many parameters were used regarding evaluation of QOL as the EORTC Head and Neck 35 assessment, UW-QOL, OHIP-14, VAS, OFS, MHI, HAD, Body Satisfaction Scale, Oral symptom check list, Swallowing, Diet consist, Pain control, Postoperative complication, and Speech. Two studies supported the surgical line of treatment for improving the QOL as compared to the prosthetic one; another two studies showed a statistically insignificant improvement in the patients’ QOL with the surgical line, while only one revealed insignificant difference in QoL with both lines of treatment.

Conclusions

Surgical rehabilitation provides a better line of treatment in improving the QOL for patients with maxillary defects. On the other hand, prosthetic has proved effectiveness in the immediate post-surgical times as temporary strategy, and it has represented a good alternative when the surgical obturation is compromised.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Glinski B, Zabek M, Urbanski J (2006) Principles of diagnosis and treatment of patients with head and neck squamous cancer. Contemp Oncol (Pozn) 6:263–267

    Google Scholar 

  2. Yanamoto S, Yamada S, Takahashi H et al (2014) Benefits of maxillectomy with internal dissection of the masticator space by transmandibular approach in the surgical management of malignant tumours of the upper gingiva and hard palate: a clinical review of 10 cases. Int J Oral Maxillofac Surg 11:1319–1325

    Article  Google Scholar 

  3. Nagy J, Braunitzer G, Antal M et al (2014) QOL in head and neck cancer patients after tumor therapy and subsequent rehabilitation: an exploratory study. Qual Life Res 1:135–143

    Article  Google Scholar 

  4. Yucel A, Cinar C, Aydin Y et al (2000) Malignant tumors requiring maxillectomy. J Craniofac Surg 11:418–429

    Article  CAS  PubMed  Google Scholar 

  5. Brown JS, Rogers SN, McNally DN, Boyle M (2000) A modified classification for the maxillectomy defect. Head Neck 2000 22(1):17–26. https://doi.org/10.1002/(SICI)1097-0347(200001)22:1<17::AID-HED4>3.0.CO;2-2

    CAS  Google Scholar 

  6. Baliarsing AS, Vinay VK, Neelima AM, Dilip KB (2010) Reconstruction of maxillectomy defects using deep circumflex iliac artery-based composite free flap. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:8–13

    Article  Google Scholar 

  7. Cordeiro PG, Santamaria EA (2000) Classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg 105(7):2331–2346. https://doi.org/10.1097/00006534-200006000-00004

    Article  CAS  PubMed  Google Scholar 

  8. Futran ND, Mendez E (2006) Developments in reconstruction of midface and maxilla. Lancet Oncol 7(3):249–258. https://doi.org/10.1016/S1470-2045(06)70616-7

    Article  PubMed  Google Scholar 

  9. Muzaffar AR, Adams WP Jr, Hatorg JM, Rohrich RJ, Byrd HS (1999) Maxillary reconstruction: functional and aesthetic considerations. Plast Reconst Surg 104(7):2172–2183. https://doi.org/10.1097/00006534-199912000-00035

    Article  CAS  PubMed  Google Scholar 

  10. Funk GF, Karnell LH, Christensen AJ (2012) Long-term health related quality of life in survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg 138(2):123–133. https://doi.org/10.1001/archoto.2011.234

    Article  PubMed  Google Scholar 

  11. Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28

    Article  CAS  PubMed  Google Scholar 

  12. Argerakis GP (1990) Psychosocial considerations of the post-treatment of head and neck cancer patients. Dent Clin N Am 34:285–305

    CAS  PubMed  Google Scholar 

  13. Hammerlid E, Persson L, Sulivan M, Westin T (1999) Quality-of-life effects of psychosocial intervention in patients with head and neck cancer. Otolaryngol Head Neck Surg 120:507–516

    Article  CAS  PubMed  Google Scholar 

  14. Depprich R, Naujoks C, Lind D, Ommerborn M, Meyer U, Kübler NR, Handschel J (2011) Evaluation of the quality of life of patients with maxillofacial defects after prosthodontic therapy with obturator prostheses. Int J Oral Maxillofac Surg 40(1):71–79. https://doi.org/10.1016/j.ijom.2010.09.019

    Article  CAS  PubMed  Google Scholar 

  15. Irish J, Sandhu N, Simpson C, Wood R, Gilbert R, Gullane P, Brown D, Goldstein D, Devins G, Barker E (2009) Quality of life in patients with maxillectomy prostheses. Head Neck 31(6):813–821. https://doi.org/10.1002/hed.21042

    Article  PubMed  Google Scholar 

  16. Rogers SN (2009) Quality of life for head and neck cancer patients—has treatment planning altered? Oral Oncol 45(4-5):435–439. https://doi.org/10.1016/j.oraloncology.2008.11.006

    Article  PubMed  Google Scholar 

  17. Dalgorf D, Higgins K (2008) Reconstruction of the midface and maxilla. Curr Opin Otolaryngol Head Neck Surg 16(4):303–311. https://doi.org/10.1097/MOO.0b013e328304b426

    Article  PubMed  Google Scholar 

  18. Rieger JM, Tang JA, Wolfaardt J, Harris J, Seikaly H (2011) Comparison of speech and aesthetic outcomes in patients with maxillary reconstruction versus maxillary obturators after maxillectomy. J Otolaryngol Head Neck Surg 40(1):40–47

    PubMed  Google Scholar 

  19. Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW, Shah JP, Spiro RH, Holland JC (1996) Quality of life of maxillectomy patients using an obturator prosthesis. Head Neck 18(4):323–334.

  20. Sharma AB, Beumer J III (2005) Reconstruction of maxillary defects: the case for prosthetic rehabilitation. J Oral Maxillofac Surg 63(12):1770–1773. https://doi.org/10.1016/j.joms.2005.08.013

    Article  PubMed  Google Scholar 

  21. Okay DJ, Genden E, Buchbinder D, Urken M (2001) Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent 86(4):352–363. https://doi.org/10.1067/mpr.2001.119524

    Article  CAS  PubMed  Google Scholar 

  22. Brown JS, Shaw RJ (2010) Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol 11(10):1001–1008. https://doi.org/10.1016/S1470-2045(10)70113-3

    Article  PubMed  Google Scholar 

  23. Nguyen CT, Driscoll CF, Coletti DP (2011) Reconstruction of a maxillectomy patient with an osteocutaneous flap and implant-retained fixed dental prosthesis: a clinical report. J Prosthet Dent 105(5):292–295. https://doi.org/10.1016/S0022-3913(11)60054-1

    Article  PubMed  Google Scholar 

  24. Marx RE (2009) Reconstruction of defects caused by bisphosphonate-induced osteonecrosis of the jaws. J Oral Maxillofac Surg 67(5):107–119. https://doi.org/10.1016/j.joms.2008.12.007

    Article  PubMed  Google Scholar 

  25. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O’Ryan F, American Association of Oral and Maxillofacial Surgeons (2014) American Association of oral and maxillofacial surgeons position paper on medication-related osteonecrosis of the jawse2014 update. J Oral Maxillofac Surg 72(10):1938–1956. https://doi.org/10.1016/j.joms.2014.04.031

    Article  PubMed  Google Scholar 

  26. Chiapasco M, Abati S, Ramundo G, Rossi A, Romeo E, Vogel G (2000) Behavior of implants in bone grafts or free flaps after tumor resection. Clin Oral Implants Res 11(1):66–75. https://doi.org/10.1034/j.1600-0501.2000.011001066.x

    Article  CAS  PubMed  Google Scholar 

  27. Bodard AG, Bemer J, Gourmet R et al (2011) Dental implants and free fibula flap: 23 patients. Rev Stomatol Chir Maxillofac 112:1–4

    Article  Google Scholar 

  28. Iizuka T, Hafliger J, Seto I, Rahal A, Mericske-Stern R, Smolka K (2005) Oral rehabilitation after mandibular reconstruction using an osteocutaneous fibula free flap with endosseous implants. Factors affecting the functional outcome in patients with oral cancer. Clin Oral Implants Res 16(1):69–79. https://doi.org/10.1111/j.1600-0501.2004.01076.x

    Article  PubMed  Google Scholar 

  29. WHOQOL (1995) The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 41:1403–1409

    Article  Google Scholar 

  30. WHOQOL (1996) What quality of life? The WHOQOL group. World Health Organization quality of life assessment. World Health Forum 17:354–356

    Google Scholar 

  31. Felce D, Perry J (1995) Quality of life: its definition and measurement. Res Dev Disabil 16(1):51–74. https://doi.org/10.1016/0891-4222(94)00028-8

    Article  CAS  PubMed  Google Scholar 

  32. Wang F, Huang W, Zhang C, Sun J, Qu X, Wu Y (2016) Functional outcome and quality of life after a maxillectomy: a comparison between an implant supported obturator and implant supported fixed prostheses in a free vascularized flap. Clin Oral Impl Res 00:1–7

    Google Scholar 

  33. Miller SA, Forrest JL (2001) Enhancing your practice through evidence-based decision making: PICO, learning how to ask good questions. J Evid Base Dent Pract 1(2):136–141. https://doi.org/10.1016/S1532-3382(01)70024-3

    Article  Google Scholar 

  34. Moher D, Liberati A, Tetzlaff J, Altman DG (2010) PRISMA group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341. https://doi.org/10.1016/j.ijsu.2010.02.007

    Article  PubMed  Google Scholar 

  35. Welch V, Petticrew M, Tugwell P, Moher D, O’Neill J, Waters E et al (2012) PRISMA-equity 2012 extension: reporting guidelines for systematic reviews with a focus on health equity. PLoS Med 9:1–7

    Article  Google Scholar 

  36. Rieger J, Bohle Iii G, Huryn J, Tang JL, Harris J, Seikaly H (2009) Surgical reconstruction versus prosthetic obturation of extensive soft palate defects: a comparison of speech outcomes. Int J Prosthodont 22(6):566–572

    PubMed  Google Scholar 

  37. Borlase G (2000) Use of obturators in rehabilitation of maxillectomy defects. Ann R Australas Coll Dent Surg 15:75–79

    CAS  PubMed  Google Scholar 

  38. Rieger JM, Wolfaardt JF, Jha N, Seikaly H (2003) Maxillary obturators: the relationship between patient satisfaction and speech outcome. Head Neck 25(11):895–903. https://doi.org/10.1002/hed.10299

    Article  PubMed  Google Scholar 

  39. Moreno MA, Skoracki RJ, Hanna EY, Hanasono MM (2010) Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects. Head Neck 32(7):860–868. https://doi.org/10.1002/hed.21264

    PubMed  Google Scholar 

  40. Lethaus B, Lie N, de Beer F, Kessler P, de Baat C, Verdonck HW (2010) Surgical and prosthetic reconsiderations in patients with maxillectomy. J Oral Rehabil 37(2):138–142. https://doi.org/10.1111/j.1365-2842.2009.02031.x

    Article  CAS  PubMed  Google Scholar 

  41. Hertrampf K, Wenz HJ, Lehmann KM, Lorenz W, Koller M (2004) Quality of life of patients with maxillofacial defects after treatment for malignancy. Int J Prosthodont 17(6):657–665

    PubMed  Google Scholar 

  42. Riaz N, Warriach RA (2010) Quality of life in patients with obturator prostheses. J Ayub Med Coll Abbottabad 22:121–125

    PubMed  Google Scholar 

  43. Kreeft AM, Krap M, Wismeijer D, Speksnijder CM, Smeele LE, Bosch SD, Muijen MSA, Balm AJM (2012) Oral function after maxillectomy and reconstruction with an obturator. Int J Oral Maxillofac Surg 41(11):1387–1392. https://doi.org/10.1016/j.ijom.2012.07.014

    Article  CAS  PubMed  Google Scholar 

  44. Chigurupati R, Aloor N, Salas R, Schmidt BL (2013) Quality of life after maxillectomy and prosthetic obturator rehabilitation. J Oral Maxillofac Surg 71(8):1471–1478. https://doi.org/10.1016/j.joms.2013.02.002

    Article  PubMed  Google Scholar 

  45. Kumar P, Alvi HA, Rao J, Singh BP, Jurel SK, Kumar L, Aggarwal H (2013) Assessment of the quality of life in maxillectomy patients: a longitudinal study. J Adv Prosthodont 5(1):29–35. https://doi.org/10.4047/jap.2013.5.1.29

    Article  PubMed  PubMed Central  Google Scholar 

  46. Said MM, Otomaru T, Yeerken Y, Taniguchi H (2017) Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects. J Prosthet Dent 118(1):108–112. https://doi.org/10.1016/j.prosdent.2016.11.003

    Article  PubMed  Google Scholar 

  47. Costa H, Zenha H, Sequeira H, Coelho G, Gomes N, Pinto C, Martins J, Santos D, Andresen C (2015) Microsurgical reconstruction of the maxilla–algorithm and concepts. Br J Plast Surg 68:89–104

    Google Scholar 

  48. Viswanathan M, Ansari MT, Berkman ND, Chang S, Hartling L, McPheeters LM, Santaguida PL, Shamliyan T, Singh K, Tsertsvadze A, Treadwell JR (2012) Assessing the risk of bias of individual studies in systematic reviews of health care interventions. Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews. March 2012. AHRQ Publication No. 12- EHC047-EF. Available at: http://www.effectivehealthcare ahrq.gov/ehc/products/322/998/MethodsGuideforCERs_Viswanathan_ IndividualStudies.pdf

  49. Genden EM, Okay D, Stepp MT, Rezaee RP, Mojica JS, Buchbinder D, Urken ML (2003) Comparison of functional and quality-of-life outcomes in patients with and without palatomaxillary reconstruction: a preliminary report. Arch Otolaryngol Head Neck Surg 129(7):775–780. https://doi.org/10.1001/archotol.129.7.775

    Article  PubMed  Google Scholar 

  50. Rogers SN, Lowe D, McNally D, Brown JS, Vaughan ED (2003) Health-related quality of life after maxillectomy: a comparison between prosthetic obturation and free flap. J Oral Maxillofac Surg 61(2):174–181. https://doi.org/10.1053/joms.2003.50044

    Article  PubMed  Google Scholar 

  51. Pompa G, Brauner E, Jamshir S, De Angelis F, Giardino R, Di Carlo S (2017) Quality of life in patients rehabilitated with palatal obturator without reconstruction versus fixed implant-prosthesis after reconstruction of maxillectomy defects. J Int Dent Med Res 10:1–8

    Google Scholar 

  52. Murphy J, Isaiah A, Wolf JS, Lubek JE (2015) Quality of life factors and survival after total or extended maxillectomy for sinonasal malignancies. J Oral Maxillofac Surg 73(4):759–763. https://doi.org/10.1016/j.joms.2014.11.002

    Article  PubMed  Google Scholar 

  53. Brauner E, Valentini V, Jamshir S, Guarino G, Battisti A, Fadda MT, Pompa G (2016) Retrospective review of 78 rehabilitated head and neck postoncological patients: a new classification method. Minerva Stomatol 65:17–38

    PubMed  Google Scholar 

  54. Australian Government, NHMRC. How to use the evidence: assessment and application of scientific evidence. Available at: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/cp69.pdf. Accessed April 24,2015

  55. Martín-Ares M, Barona-Dorado C, Guisado-Moya B, Martínez-Rodríguez N, Cortés-Bretón-Brinkmann J, Martínez-González JM (2015) Prosthetic hygiene and functional efficacy in completely edentulous patients: satisfaction and quality of life during a 5-year follow-up. Clin Oral Implants Res 20:1–6

    Google Scholar 

  56. Awad MA, Lund JP, Shapiro SH, Locker D, Klemetti E, Chehade A, Savard A, Feine JS (2003) Oral health status and treatment satisfaction with mandibular implant overdentures and conventional dentures: a randomized clinical trial in a senior population. Int J Prosthodont 16(4):390–396

    PubMed  Google Scholar 

  57. Dings JP, Mizbah K, Bergé SJ, Meijer GJ, Merkx MA, Borstlap WA (2014) Secondary closure of small- to medium-size palatal defects after ablative surgery: reappraisal of reconstructive techniques. J Oral Maxillofac Surg 72(10):2066–2076. https://doi.org/10.1016/j.joms.2014.04.036

    Article  PubMed  Google Scholar 

  58. Rana M, Kanatas A, Herzberg PY, Khoschdell M, Kokemueller H, Gellrich NC, Rana M (2015) Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma. Br J Oral Maxillofac Surg 53(4):364–370. https://doi.org/10.1016/j.bjoms.2015.01.019

    Article  CAS  PubMed  Google Scholar 

  59. Gellrich NC, Schimming R, Schramm A, Schmalohr D, Bremerich A, Kugler J (2002) Pain, function, and psychologic outcome before, during, and after intraoral tumor resection. J Oral Maxillofac Surg 60(7):772–777. https://doi.org/10.1053/joms.2002.33244

    Article  PubMed  Google Scholar 

  60. Kollbrunner J, Zbären P, Quack K (2001) Quality of life stress in patients with larger tumors of the mouth. A descriptive study of psychosocial effects of illness and primary surgery therapy in 3 parts d1: quantity and quality of life. HNO 49(12):985–997. https://doi.org/10.1007/s001060170003

    Article  CAS  PubMed  Google Scholar 

  61. Aarstad AK, Beisland E, Aarstad HJ (2012) Personality, choice of coping and T stage predict level of distress in head and neck cancer patients during follow-up. Eur Arch Otorhinolaryngol 269(9):2121–2128. https://doi.org/10.1007/s00405-011-1884-4

    Article  PubMed  Google Scholar 

  62. van der Sloot PG (2003) Hard and soft palate reconstruction. Curr Opin Otolaryngol Head Neck Surg 11(4):225–229. https://doi.org/10.1097/00020840-200308000-00001

    Article  PubMed  Google Scholar 

  63. Batchelor AG, Palmer JH (1990) A novel method of closing a palatal fistula: the free fascial flap. Br J Plast Surg 43(3):359–361. https://doi.org/10.1016/0007-1226(90)90089-I

    Article  CAS  PubMed  Google Scholar 

  64. Boyes-Varley JG, Howes DG, Davidge-Pitts KD, Branemark I, McAlpine JA (2007) A protocol for maxillary reconstruction following oncology resection using zygomatic implants. Int J Prosthodont 20:521–531

    PubMed  Google Scholar 

  65. Hu YJ, Hardianto A, Li SY, Zhang ZY, Zhang CP (2007) Reconstruction of a palatomaxillary defect with vascularized iliac bone combined with a superficial inferior epigastric artery flap and zygomatic implants as anchorage. Int J Oral Maxillofac Surg 36(9):854–857. https://doi.org/10.1016/j.ijom.2007.04.011

    Article  CAS  PubMed  Google Scholar 

  66. Weischer T, Schettler D, Mohr C (1997) Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants 12:211–214

    CAS  PubMed  Google Scholar 

  67. Leles CR, Leles JL, de Paula Souza C, Martins RR, Mendonc EF (2010) Implant-supported obturator overdenture for extensive maxillary resection patient: a clinical report. J Prosthodont 19:240–244

    Article  PubMed  Google Scholar 

  68. Schliephake H, Jamil MU (2002) Prospective evaluation of quality of life after oncologic surgery for oral cancer. Int J Oral Maxillofac Surg 31(4):427–433. https://doi.org/10.1054/ijom.2001.0194

    Article  CAS  PubMed  Google Scholar 

  69. Shepherd KL, Fisher SE (2004) Prospective evaluation of quality of life in patients with oral and oropharyngeal cancer: from diagnosis to three months post-treatment. Oral Oncol 40(7):751–757. https://doi.org/10.1016/j.oraloncology.2004.01.018

    Article  PubMed  Google Scholar 

  70. Rogers SN, Lowe D, Humphris G (2000) Distinct patient groups in oral cancer: a prospective study of perceived health status following primary surgery. Oral Oncol 36:529–538

    Article  CAS  PubMed  Google Scholar 

  71. Allison PJ, Locker D, Feine JS (1997) Quality of life: a dynamic construct. Soc Sci Med 45:221–230

    Article  CAS  PubMed  Google Scholar 

  72. Breetvelt IS, Dam V (1991) FS (1991) under reporting by cancer patients: the case of response-shift. Soc Sci Med 32(9):981–987. https://doi.org/10.1016/0277-9536(91)90156-7

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Prosthodontics, Faculty of Dentistry, University of Beni-Suef, Beni-Suef, 62511, Egypt

    M. Y. Sharaf & A. F. Shaker

  2. Department of Prosthodontics, Faculty of Oral and Dental Medicine, University of Cairo, Cairo, Egypt

    S. I. Ibrahim & A. E. Eskander

Authors
  1. M. Y. Sharaf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. I. Ibrahim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. E. Eskander
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. F. Shaker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Y. Sharaf.

Ethics declarations

Conflict of interest

None of the authors has a financial interest in this manuscript.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharaf, M.Y., Ibrahim, S.I., Eskander, A.E. et al. Prosthetic versus surgical rehabilitation in patients with maxillary defect regarding the quality of life: systematic review. Oral Maxillofac Surg 22, 1–11 (2018). https://doi.org/10.1007/s10006-018-0679-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-018-0679-9

Keywords

Search

Navigation