91 Oral functioning in maxillectomy patients 4 Results A total of 20 patients were included in this cross-sectional study. Of these 20 patients, eleven (six according to the ART protocol, five according to Rohner’s technique) had maxillae reconstructed by free vascularized fibula flaps in Edmonton and nine patients had received an implant supported obturator prosthesis in Maastricht. The medical history and demographic data of the ten men (50%) and ten women (50%) are presented in Table 1. No significant differences were found between the reconstruction group and the obturator group with regard to sex, duration since dental oral rehabilitation, cause for maxillectomy, and adjuvant radiotherapy. Most patients had a defect not involving the orbit, corresponding a vertical Brown component I (n = 1) or II (n = 15). However, some of the data were different between the two groups. Patients with an obturator were older, had a larger horizontal Brown component than the reconstructed patients (p = .034). In addition, the dental status of the maxilla (p = .000), mandible (p = .014), and number of occlusal units (p = .000) were less for the obturator group. Eleven patients with a mean age of 45 years (range 19–66) were surgically reconstructed and received a total of 46 implants in the (neo)maxilla. One received an implant supported denture, the other ten received fixed dental prosthesis on implants. A natural dentition was preserved in the lower jaw in ten patients. In one patient, the lower jaw was rehabilitated with a fixed dental prosthesis on implants. In the implant supported obturator group the mean age was 64 years (range 47-78). Four of these patients received implants in the remaining parts of the maxilla, in one patient after bone-augmentation. In the remaining five cases, no viable maxillary structure was left for implant placement. These patients received implants in remaining bone structures useful for implantation, such as the pterygoid bone, the zygomatic bone or paranasal pillars of the nasal aperture. In total 42 implants were placed in the maxillary structures of which 32 were used to support the obturator prostheses. Of the ten unused implants, five were lost, two were damaged and two were non-functional. In the lower jaw: 3 patients had a natural dentition, 5 patients had an implant supported denture, and 1 patients had a conventional denture added to an implant supported obturator. Patients with a reconstructed maxilla and patients with an implant supported obturator prosthesis had similar mean MAI (18.20 ± 2.38 resp. 18.66 ± 1.37; p = .614). The seven overlapping questions of the OHIP-14 and OHIP-EDENT also showed no differences in masticatory ability between the two groups (Table 2).
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