Assessment of swallowing and masticatory performance in obturator wearers: a clinical study

PURPOSE: To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS: Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS: Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION: Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

Assessment of the quality of life in maxillectomy patients: A longitudinal study

PURPOSE: To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. MATERIALS AND METHODS: Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of P<.05 was considered statistically significant. RESULTS: The quality of life after rehabilitation with obturator prosthesis was 81.48% (+/-13.64) on average. On item-level, maximum mean scores were obtained for items problem with teeth (1.87 +/- 0.94), pain in mouth (1.80 +/- 0.92), trouble in eating (1.70 +/- 0.88), trouble in talking to other people (1.60 +/- 1.22), problems in swallowing solid food (1.57 +/- 1.22) and bothering appearance (1.53 +/- 1.04); while minimum scores were obtained for the items coughing (1.17 +/- 0.38), hoarseness of voice (1.17 +/- 0.53), painful throat (1.13 +/- 0.43), trouble in having social contacts with friends (1.10 +/- 0.40) and trouble having physical contacts with family or friends (1.10 +/- 0.31). CONCLUSION: Obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects.