Comparative Evaluation of Functional and Quality of Life Outcomes in Conventional and Soft-Liner Relined Obturators for Patients With Maxillofacial Defects

Abstract

Background and objective Oral cancer is the sixth most common cancer worldwide. The prevalence of mucormycosis, a progressive fungal infection affecting the nasal and paranasal sinuses, is also on the rise, especially in patients after COVID-19 treatment. Surgical resection frequently employed in these cases results in maxillary defects which lead to functional and aesthetic impairments. Obturator prostheses are used for the rehabilitation of these maxillofacial defects. However, the choice of material and design can have an impact on patient outcomes. The present study aims to compare the maxillofacial obturators lined with a soft-liner, in terms of masticatory performance, speech parameters, and quality of life (QoL) of patients with maxillofacial defects with conventionally used obturators. Materials and methods This in vivo study was conducted in P.G. Department of Prosthodontics and Crown & Bridge, S.C.B. Dental College and Hospital, Cuttack after receiving approval from the Institutional Ethical Committee and Clinical Trial Registry-India (CTRI) (Reg. No. Trial REF/2022/07/056836). In this cross-over trial, 27 patients meeting the inclusion and exclusion criteria were provided with a conventional maxillofacial obturator which was later on relined with a tissue soft-liner. Parameters such as masticatory performance, speech and QoL were evaluated for both conventional and relined prosthesis. The masticatory performance was evaluated using a colour-changing chewing gum with a scoring system based on the colour change observed after 60 seconds of chewing the gum. Results The masticatory performance was better with the relined obturator (mean: 3.22) compared to the conventional obturator (2.74) yielding a statistically significant result (p=0.028). Analysis of speech parameters showed that the relined dentures had lower jitter (2.13 vs. 2.47) with a statistically significant result (p=0.012). Parameters such as shimmer and fundamental frequency, although not statistically significant, were lower for the relined prosthesis compared to their conventional counterparts. Also, the participants with soft-liner relined obturators had higher quality of life (mean: 170.4) than participants with conventional obturators (mean: 179.1). However, this difference was not statistically significant (p=0.42). Conclusions The present study demonstrates that soft-liner relined obturators offer superior masticatory performance and speech outcomes compared to conventional obturators in patients with maxillofacial defects. These findings suggest that the use of soft-liner relined obturators may be a more effective option for rehabilitating patients with maxillofacial defects, improving their functional and aesthetic outcomes. Although quality of life scores were higher for participants with soft-liner relined obturators, the difference was not statistically significant. Further studies with larger sample sizes and longer follow-up periods are recommende...