REVIEW PAPER
Clinical protocol during prosthetic treatment of patients with tissue deficiences in oral and
facial areas
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Katedra Protetyki Stomatologicznej, Instytut Stomatologii Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie
Submission date: 2019-05-06
Final revision date: 2019-08-02
Acceptance date: 2019-08-12
Publication date: 2019-08-12
Corresponding author
Monika Maślak-Bereś
Instytut Stomatologii CMUJ, Katedra Protetyki Stomatologicznej, Montelupich 4, 31-155, Krakow, Polska
Prosthodontics 2019;69(3):322-331
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ABSTRACT
This article draws on the literature and practical experience to present a clinical protocol
for the prosthetic treatment of surgical patients for whom there is no possibility of
temporary or permanent restoration of the lost structures. Localization of the tumor, its
stage, and its direction of infiltration affect the margin of resection, and thus determine the
functional and esthetic deficiencies. The main purpose of reconstructive treatment is to
enable patients who have undergone surgery to return to normal everyday life and
presence in the community. Restoration of the facial appearance and of the functions of
the stomatognathic system—such as chewing, swallowing, and the ability to speak—helps
patients feel psychologically better and has a positive effect on the overall treatment
results. Clinical protocol during prosthetic rehabilitation of such patients often requires
individual and uncommon solutions which present difficulties even for skilled and
experienced clinicians. We here pay special attention to the differences between standard
procedures and the clinical protocol for prosthetic treatment of patients with tissue
deficiencies in the maxillofacial area. We discuss complications in the surgical approach,
including those caused by radiotherapy and chemotherapy. Insufficient prosthetic area with
increased resilience, contractive surgical scars, and often uneven muscle function lead to
additional difficulties in the rehabilitation of patients after surgery. It is important to
remember that oncological patients require constant multidisciplinary care. Cooperation
between prosthodontists and oncologists, physiotherapists, psychologists, speech
therapists, and other specialists, as needed by the patient’s condition, is of crucial
importance.