Abstract
Aim This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020. Results 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation. Conclusion Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.
Highlights
Management of patients who presents with such malignancy mostly necessitates surgical removal of a major portion of the palate with ablative surgery
This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it
The application of finite element analysis (FEA) has been used in limits in the identification of stress distribution in MFPs which may be due to the complexity of modeling the defects, simulation of the corresponding prosthesis, and the time involved
Summary
Management of patients who presents with such malignancy mostly necessitates surgical removal of a major portion of the palate with ablative surgery. The resultant paltal defect after surgery could be small or massive (when involves removal of a major portion of the palate, maxillary sinus, and/or nasal cavity). The patient’s quality of life often collapses following the surgical resection of the tumor mass because of the corruption of function, speech, and aesthetics [1]. To overcomes the functional and psychological impact of the surgery, a surgical microvascular and/or prosthetic reconstruction must be carried out to improve the patient quality of life [2, 3]. Maxillofacial prostheses (MFPs) are considered a cost-effective treatment option to reconstruct the lost dentition and missing structures in patients suffering from major maxillary defects [5, 6]. Even though many classifications have been introduced to distinguish the maxillary defect [7,8,9,10]; Aramany’s classification was the most one followed by researchers due to its simplicity and smoothly communication among the maxillofacial prosthodontists [11]
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