65 QOL related to mastication in maxillectomy patients 4 Results Clinical features of patients Twenty-two patients with substantial loss of maxillary/midfacial substance and edentulism in the remaining maxillae were eligible to participate in this cross-sectional study. Nineteen patients agreed to participate, two patients rejected the invitation, and one patient did not respond. The medical history and demographic data of the 11 men (57.9%) and eight women (42.1%) are shown in Table 1. Regarding sex, age, reason for maxillectomy, adjuvant radiotherapy, and dental status in the lower jaw, no significant differences were found between the two patient groups. According to Brown’s classification, the maxillary defects ranged from Ia to IId. Two patients only had a defect of the soft palate (SP), which is not included in Brown’s classification. The defects in the group of patients with an implant-supported obturator prosthesis were significantly larger and more ventral than the defects in the group with conventional obturator prostheses, making prosthetic rehabilitation more challenging (see also Table 1). On average, the patients with implant-supported obturating prostheses were interviewed 3.8 years after prosthetic rehabilitation (range: 1 month-7.4 years), and 4.8 years (range: 4 months-8.7 years) in the conventional obturator group. Thirteen patients, five with implant-supported prostheses and nine with conventional obturator prostheses, had a history of adjuvant radiotherapy (56-70Gy) due to cancer treatment. In Group 1 (nine patients), the mean age was 64 years (range 47-78). Four of these patients received implants in the remaining parts of the maxilla; one patient received implants after bone-augmentation. In the remaining five cases, no viable maxillary structure was left for implant placement. These patients received implants in the remaining bone structures useful for implantation, such as the pterygoid bone, the zygomatic bone, or the paranasal pillars of the nasal aperture. In total, 42 implants were placed to support the obturator prostheses, of which four were lost in a total of three patients. Three implants were lost before loading due to lack of osseointegration; the fourth showed good osseointegration but was lost 3 years after loading. These patients had undergone radiation treatment: two after implant placement, and one before implant placement. In three patients of Group 1, the natural dentition in the lower jaw was preserved. In four of the remaining six patients, the lower jaw dentures were implant-retained.
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