title: Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects.
abstract: BACKGROUND
  The healing pattern after surgical resection of tumors of the oral cavity involving the maxilla may vary from one patient to another. The result may be open communication between the oral and nasal cavities (open defect) or complete oronasal separation after healing of the defect area (closed defect).
  
  
  OBJECTIVE
  The purpose of this clinical study was to compare masticatory function and oral health-related quality of life (OHRQoL) between patients with closed and open defects who had undergone a partial maxillectomy and were wearing dentomaxillary prostheses.
  
  
  METHODS
  Thirty-eight participants who had undergone a partial maxillectomy and who were wearing dentomaxillary prostheses were enrolled between September 2014 and April 2016. Participants were assigned to 2 groups according to the type of defect after healing: 19 participants had a closed defect, and 19 participants had an open defect. Masticatory function was evaluated objectively and subjectively. The objective measurement was food-mixing ability, which was assessed using color-changeable chewing gum. The subjective measurement was perceived mastication ability, rated as a masticatory score based on the patient's responses to a 35-item food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI questionnaire consists of 12 items reflecting 3 hypothesized domains of the impact of oral disease: physical function, psychosocial function, and pain or discomfort. Differences in the scores obtained by the 3 measurements were compared between the 2 groups, using the Wilcoxon rank-sum test (α=.05).
  
  
  RESULTS
  No significant differences were seen between the 2 groups in objective mixing ability, subjective masticatory score, or GOHAI (P>.05). Regarding the GOHAI physical function domain, only the swallowing item was significantly lower (P=.025) in participants with an open defect than in participants with a closed defect. Regarding the GOHAI psychological function domain, the item related to patients' psychological worries or concerns about their teeth, gingival tissue, or dentures was significantly lower (P=.045) in patients with an open defect than in those with a closed defect. Other items related to physical function, psychological function, and pain or discomfort were not significantly different (P>.05) between the 2 groups.
  
  
  CONCLUSIONS
  The closed or open defect in patients who had undergone a partial maxillectomy may not influence patients' masticatory function and overall OHRQoL if they have adequate prosthetic rehabilitation. However, special consideration should be given to patients with an open defect with regard to swallowing function and psychological concerns in order to improve their OHRQoL.
authors.affiliation: Graduate student, Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Said
authors.affiliation: Assistant Professor, Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: otomaru.mfp@tmd.ac.jp.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Otomaru
authors.affiliation: Graduate student, Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yesiboli
authors.initials: Y
authors.lastname: Yeerken
authors.affiliation: Professor and head of Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Taniguchi
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003430:Cross-Sectional Studies; D003679:Deglutition; D003832:Denture, Partial, Removable / Q000523:psychology*; D004435:Eating / Q000502:physiology; D005163:Factor Analysis, Statistical; D005260:Female; D005502:Food; D015577:Geriatric Assessment; D006801:Humans; D007564:Japan; D007576:Jaw, Edentulous, Partially / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008409:Mastication / Q000502:physiology*; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D008875:Middle Aged; D009909:Oral Health; D011183:Postoperative Complications; D011788:Quality of Life; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014070:Tooth