Prosthetic Rehabilitation

Abstract

Loss of facial anatomy resulting from disfigurement secondary to trauma, surgical excision to eradicate benign or malignant lesion, or anatomical malformation resulting from congenital anomalies represents a loss of one’s three-dimensional signature/identity. The psychological implications stemming from being different from the norm have significant impacts on ones’ self-image. Since the focus of this text is management of malignancy of the facial structures, this chapter will limit itself to facial prosthetic rehabilitation associated with cancer management.

A variety of interventions for head and neck cancer management can be considered such as surgical excision/resection, radiotherapeutic management either as a single modality or in conjunction with surgery and/or chemotherapy in an adjuvant or concomitant approach. While Mohs surgical interventions attempt to address management of malignancy through chemo–surgical approaches for tissue preservation, the approach needed for addressing Maxillofacial Prosthodontic rehabilitation of lost/compromised facial anatomy calls for an entirely alternative approach. The mandate for such prosthodontic rehabilitative efforts calls for a stable tissue base to support and retain either an adhesive, mechanical, or implant retained craniofacial prosthesis. Appropriately addressing the tissue base is a key element for predictable and successful prosthodontic rehabilitation.

The information in this chapter represents an overview of the salient issues associated with craniofacial prosthetic rehabilitation. Four subcategories for the most commonly encountered treatments will be presented which are nasal, auricular, orbital, and multisite prostheses. One common thread for interventions of this type is coordination of care amongst the health-care providers that should include a Maxillofacial Prosthodontist at the time of the presurgical work-up.