Masticatory Performance in Postmaxillectomy Patients with Edentulous Maxillae Fitted with Obturator Prostheses

Purpose: Oral cancer develops frequently in older populations. In Japan, the incidence of oral and pharyngeal cancer is 9,201 per year, with such tumors accounting for 1.74% of all cancers. Although obturator prostheses play an important role in the rehabilitation of postmaxillectomy patients, clinicians sometimes experience difficulty in placing obturator prostheses in edentulous maxillae, and criteria for the objective evaluation of treatment outcome have yet to be established. The present study aimed to investigate postsurgical factors influencing the masticatory performance of postmaxillectomy patients with edentulous maxillae fitted with obturator prostheses. Materials and Methods: The extent of the hard palate defect, status of the mandibular dentition, mouth-opening distance, and maximum occlusal force were investigated, and masticatory performance was measured using a testing gummy jelly in 27 postmaxillectomy patients with edentulous maxillae fitted with obturator prostheses. The influence of these items was evaluated quantitatively, and theoretical masticatory performance for each subject was calculated using multiple-regression analysis (quantification method type 1). Results: Although average masticatory performance was almost equivalent to that of healthy, independent older patients with occlusal support classified as Eichner C, considerable individual variation was noted among subjects. The order of strength of influence on masticatory performance was identified by category weight: extent of hard palate defect > status of posterior mandibular teeth > maximum occlusal force > mouth-opening distance. A relatively high correlation (R2 = 0.78, P .01, Pearson correlation coefficient) was evident between theoretical and actual values. Conclusion: Masticatory performance could be predicted by evaluating postsurgical factors in patients with edentulous maxillae fitted with obturator prostheses.