59 QOL related to mastication in maxillectomy patients 4 Introduction Maxillary defects due to trauma, infections, or tumour resections can result in tremendous limitations in daily life, depending on the size and anatomical location of the defect [1, 2]. Surgical reconstruction of these defects remains challenging and controversial due to the complex three-dimensional anatomy of the maxilla and midface [3-5]. Preserving the oronasal separation and a clear nasal airway is important for optimal mastication, deglutition, and phonetics [5]. These oral functions are essential for the total rehabilitation of the patient and, therefore, directly related to quality of life issues [6, 7]. Microsurgical repair is regarded as the standard option in reconstructive surgery of the face, depending on the defect size and the indication [3, 8]. However, excellent facial contour, function, and acceptable aesthetics can seldom be achieved with a single-stage procedure [9]. A considerable number of these patients will consequently remain deprived of dental rehabilitation and will not return to normal food intake [10]. Nonetheless, prosthetic obturation appears to be the preferred treatment modality for many patients, which generally leads to an improvement of masticatory performance [2, 11, 12]. However, prosthodontic treatment is challenging due to technical limitations, such as poor retention, instability of the obturator prosthesis, and oronasal incompetence [11]. Retention of the obturator prosthesis is very difficult to achieve, especially in edentulous patients. Nevertheless, implants have been placed successfully in the residual maxillary alveolar process, the pterygoid, and zygomatic bone for maxillary prosthetic rehabilitation [13, 14]. To the best of our knowledge, the literature lacks objective masticatory performance testing that is combined with patient-reported oral health-related quality of life (OHRQoL) after prosthetic obturation of edentulous maxillectomy patients [15-20]. Therefore, the aim of this study was to compare the masticatory performance and OHRQoL of edentulous maxillectomy patients with and without implant-supported obturator prostheses.
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