Obturator prostheses versus free tissue transfers: A systematic review of the optimal approach to improving the quality of life for patients with maxillary defects.
BACKGROUND
Patient perspectives on the treatment options for maxillary defects, which include free tissue transfers or obturator prostheses, may help eliminate current uncertainty as to the best choice of treatment plan.


OBJECTIVE
The purpose of this systematic review was to evaluate the quality of life (QoL) of patients with maxillary defects who had undergone restoration with obturator prostheses and/or free tissue transfers.


METHODS
A systematic search of Medline/PubMed and Web of Science databases for articles published before April 2015 was performed by 2 independent reviewers. A manual search of articles published from January 2005 to March 2015 was also conducted. Studies published in English that evaluated the QoL in patients with head and neck cancers were included. The Cohen kappa method was used to calculate inter-reviewer agreement.


RESULTS
Ten studies were included. The University of Washington Head and Neck Questionnaire (UW-QOL) was most commonly used to measure QoL. The majority of maxillary defects were Class IIa-b. Two studies reported that the global QoL for patients with obturator prostheses is equivalent to or even better than that of other chronic disease populations. One study revealed no significant difference in QoL when the 2 treatment options were compared.


CONCLUSIONS
The limited data indicate that the QoL of patients treated with obturator prostheses and that of patients free of tumors is similar. Well-designed clinical studies are necessary to draw definitive conclusions about how obturator prostheses compare with free tissue transfers in terms of affecting patient QoL.
Assistant, Dental Oncology Service, Cancer Institute of Sao Paulo State (ICESP), Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: thais.brandao@icesp.org.br.
Thais Bianca
TB
Brandão
Assistant, Cancer Institute of Sao Paulo State (ICESP), Sao Paulo, Brazil.
Aljomar José
AJ
Vechiato Filho
Doctoral student, Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Sao Paulo, Brazil.
Victor Eduardo de Souza
VE
Batista
Assistant, Cancer Institute of Sao Paulo State (ICESP), Sao Paulo, Brazil.
Maria Cecília Querido
MC
de Oliveira
Professor, Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil.
Alan Roger
AR
Santos-Silva
D006258:Head and Neck Neoplasms; D006801:Humans; D008437:Maxilla / Q000473:pathology*; D010158:Palatal Obturators; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D011795:Surveys and Questionnaires