218 Chapter 7 QLQ-C30 and the QLQ-H&N35, lack the discriminatory power to measure the effects of prosthetic treatment on mastication, swallowing, speech, aesthetics, retention, and pain. In 2004, the Liverpool Oral Rehabilitation Questionnaire (LORQ) was developed to better measure the impact of prosthetic treatment on the quality of life of patients with HNC [28-31]. However, a validated Dutch version of the LORQ was not available. To be able to use the LORQv3 for Dutchspeaking patients, we translated the LORQv3 into Dutch and adapted it to the Dutch situation in Chapter 3.The original English LORQv3 was translated into Dutch using the forward–backward approach, resulting in the LORQv3NL. The internal consistency of the LORQv3-NL was tested in 158 participants from the Radboudumc Faculty of Dentistry, the Center for Special Oral Care of Radboudumc and Maastricht UMC+ and in general practices. We also evaluated internal consistency, reliability, and validity. Test-retest reliability was performed in 34 of these 158 patients. For convergent validity, the correlation between the LORQv3-NL and the OHIP-NL14 was examined in 17 of 158 patients. Internal consistency (Cronbach’s α = 0.89 for items 1-17) and test-retest reliability (weighted kappa values ranging from 0.401 to 0.830 for items 1-17), and convergent validity (R2 = 0.642) were satisfactory. With the LORQv3-NL, we seem to have a good instrument for the assessment of prosthesis discomfort and prosthesis intolerance. To date, the LORQv3 has been translated and validated in a Turkish version [32] and a German version [33], and shows high validity and reliability in all four languages. The questionnaire has been successfully used in the United Kingdom, Turkey, the Netherlands, Germany, and for several studies in India, making it a suitable questionnaire for multinational research on OHRQoL in patients with HNC. Rehabilitation of the edentulous maxilla with defects In the maxilla, the lack of retention and stability of the full denture may be due to the effects of cancer treatment or to trauma or infection. In particular, if the hard palate is defective, the stable denture base is lost. Such a palatal defect results in leakage through the nose, decreased speech intelligibility due to air loss, and decreased masticatory performance, leading to limitations in daily life [34-36]. Reconstruction of these defects remains a challenge for both surgeons and prosthodontists due to the complex three-dimensional anatomy of the maxilla and midface [37-40]. The complexity of these defects is reflected in the various classification systems that have been developed, of which the Okay classification and the Brown classification are the most commonly used [41, 42]. The Brown classification has the advantage of describing a horizontal or dentoalveolar component that corresponds to the functional side of the defect
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