Oral health-related quality of life after rehabilitation with maxillary obturators: A comparison of patients with maxillectomy defects associated with cancer and post-COVID-19 mucormycosis

Gunjan Chouksey; Jinesh Dugad; Vikas Gupta; Kanchan Dholam; Pankaj Goel; Rupali Choure

doi:10.1016/j.prosdent.2023.11.009

Oral health-related quality of life after rehabilitation with maxillary obturators: A comparison of patients with maxillectomy defects associated with cancer and post-COVID-19 mucormycosis

J Prosthet Dent. 2023 Dec 15:S0022-3913(23)00757-6. doi: 10.1016/j.prosdent.2023.11.009. Online ahead of print.

Authors

Gunjan Chouksey¹, Jinesh Dugad², Vikas Gupta³, Kanchan Dholam⁴, Pankaj Goel⁵, Rupali Choure⁶

Affiliations

¹ Associate Professor, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India. Electronic address: gunjan.dentistry@aiimsbhopal.edu.in.
² Former Assistant Professor, Department of Dentistry, Tata Memorial Hospital - Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
³ Additional Professor, Department of ENT-HNS, All India Institute of Medical Sciences, Bhopal, India.
⁴ Former Professor and Head, Department of Dentistry, Tata Memorial Hospital, Mumbai, India.
⁵ Professor and Head, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India.
⁶ Senior Lecturer, Department of Prosthodontics and Crown and Bridge, People's Dental Academy, Bhopal, India.

PMID: 38103969
DOI: 10.1016/j.prosdent.2023.11.009

Abstract

Statement of problem: Maxillectomy alters function and esthetics, negatively affecting oral health-related quality of life (OHRQoL). OHRQoL has been assessed after prosthetic rehabilitation in patients with maxillectomy associated with cancer. However, OHRQoL studies after prosthetic rehabilitation in patients with coronavirus disease 2019 (COVID-19) associated mucormycosis are lacking.

Purpose: The purpose of this clinical study was to compare OHRQoL before and after rehabilitation with maxillary obturators in patients with maxillectomy defects associated with cancer and post COVID-19 mucormycosis.

Material and methods: The study was conducted at 2 centers. A total of 47 participants who underwent maxillectomy because of cancer were included from the first center, and 32 participants who underwent maxillectomy because of post COVID-19 associated mucormycosis of the maxilla were included from the second center. Participants were asked to rate their dental problems on a Likert scale using Oral Health Impact Profile-14 (OHIP-14) before and after prosthodontic rehabilitation. The difference between scores among groups for each item and overall score was compared by using the Wilcoxon Rank-Sum test (α=.05). A linear mixed-effects model was fitted to account for the repeated measures within individuals. A random intercept for each participant was included to account for the within-subject correlation.

Results: An overall improvement in the OHRQoL of participants was found in both groups. The mean total OHIP-14 score for the cancer group decreased from 24.2 at the prerehabilitation stage (Pre-R) to 9.5 at the postrehabilitation stage (Post-R). The magnitude of improvement was higher for the post COVID-19 associated mucormycosis group with a reduction in the mean total OHIP-14 score of 52.0 (Pre-R) to 6.5 (Post-R). The mean change in OHIP-14 scores after rehabilitation was 15 (95% CI 10-19) in the cancer group but significantly larger at 45 (95% CI 41-49) in the mucormycosis group. The P value for the mean total OHIP-14 score at Pre-R was <.001 and at Post-R was.031. The interaction term between groups and time was significant, indicating different effects between groups with time.

Conclusions: Comparison of the OHRQoL after rehabilitation with prostheses among patients with cancer and post COVID-19 associated mucormycosis showed that the OHRQoL scores, although much higher among patients with mucormycosis before rehabilitation (compared with patients with cancer), were almost similar after rehabilitation.