Aesthetic outcome following prosthetic rehabilitation after ablative maxillary surgery. A Preliminary Study

Abstract

Objective: Psychological impact of poor dento-facial aesthetics constitutes a major part of the low quality of life in maxillectomy patients. The  purpose of this study was to present the aesthetic outcome following prosthetic rehabilitation after ablative maxillary surgery.
Method: All consecutive patients that had surgery for tumours affecting the upper jaw and gave their consent were included in the study.  Classification of maxillectomy was based on the Brown's classification. Facial attractiveness after final prosthetic rehabilitation was graded by two independent observers with a modified Liekert scale into four grades. For the purpose of comparison of facial attractiveness, the patients were divided into 2 groups: those below 2A and those above 2A.
Result: Seventeen patients with tumours affecting the upper jaw were operated. Ten (58.8%) were females and 7 (41.2%) were males. The age range was 6-65 years, mean (SD), 37.6 (18.5) years. Two (11.8%) cases were children. There were 3 (17.6%) cases in the level 1, one case was 1A, two cases were 1B; 11 (64.7%) cases in level 2, 8 (47.1%) cases were 2A, 3 (17.6%) cases were 2B and 3 (17.6%) cases in level 3. Two (11.8%) patients, both in the level 2B had moderately attractive appearances and also, 2(11.8%) patients in the levels 2B and 3B respectively had least attractive appearances.
Conclusion: Majority of our patients had resections at levels 2A and below and there was no obvious difference between the two groups, immediate prosthetic obturation may have minimized collapse of midface in those above 2A.

Key words: Classification, Maxillectomy, Prosthetic rehabilitation, Aesthetics