Abstract
This study sought to geometrically evaluate the effect of a mandibular prosthesis on facial asymmetry in patients with one of two different types of mandibulectomy defect. Facial data from 20 participants (9 men and 11 women; mean age 68 years) with either a reconstructed segmental defect (segmental group,n = 10) or a marginal mandibulectomy defect (marginal group, n =10) were acquired with a non-contact three-dimensional (3D) digitizer. Facial asymmetry was evaluated by superimposing a facial scan onto its mirror scan using 3D evaluation software. Facial scans with and without the mandibular prosthesis in place were also superimposed to evaluate the effect of the mandibular prosthesis. Facial asymmetry differed significantly between subjects with and without the prosthesis in the segmental group (P = 0.005) but not in the marginal group (P = 0.16). There was no significant difference in the effect of the prosthesis on facial appearance between the two groups (P = 0.052). The ratio of 3D deviation of facial asymmetry without the prosthesis and in the mirror scan with the prosthesis differed significantly between the two groups (P = 0.01). Placement of a mandibular prosthesis has a notable effect on facial asymmetry in patients with segmental mandibulectomy defects.
Highlights
Patients who undergo mandibulectomy have numerous problems with oral function and esthetics due to anatomical compromise resulting from tumor resection [1,2,3]
There were no significant differences in facial asymmetry between the original and mirrored faces with and without the prosthesis in the marginal group (P = 0.160; Fig. 4)
We found that the median of facial asymmetry with a prosthesis was smaller than that without a prosthesis in the segmental group, and that facial asymmetry was significantly improved by the use of a mandibular prosthesis in all segmental mandibulectomy patients
Summary
Patients who undergo mandibulectomy have numerous problems with oral function and esthetics due to anatomical compromise resulting from tumor resection [1,2,3]. The objective evaluation of symmetry is considered superior to subjective evaluation because it has the advantage of repeatability and reliability, is widely accepted in the scientific community, and can be used to standardize evaluation [6]. This method has been reported in other fields of dentistry, including orthogenetic surgery [7], maxillofacial surgery [8], and orthodontics [9]. Digitized approaches that use 3D imaging technologies to capture facial morphologic structure are well documented in the literature [10,11,12,13]. In the field of maxillofacial prosthetics, Aswehlee et al [14] evaluated the feasibility and accuracy of non-contact 3D digitization systems for capturing facial defects and concluded that 3D digitizers were effective for facial defects, with laser beam light-sectioning technology providing the most accurate digitization
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