Etiological trends, defect classification, and prosthetic rehabilitation of maxillofacial defects: A nine-year retrospective institutional analysis.

Abstract

Aim: The aim of this study was to analyze the distribution of maxillofacial defects with respect to etiology, defect classification, demographic characteristics, and prosthetic treatment modalities over a 9-year period at a tertiary care center.

Settings and design: This retrospective study analyzed institutional data from a tertiary care hospital, encompassing patients rehabilitated with maxillofacial prostheses over a 9-year period (2017-2025).

Materials and methods: Clinical records of patients rehabilitated with maxillofacial prostheses between 2017 and 2025 were reviewed. Data extracted included demographic characteristics, etiology of defects, classification systems (Aramany, Cantor-Curtis, Veau, and Cordeiro), and type of prosthesis delivered. All variables were predefined and uniformly recorded to ensure consistency in data extraction.

Statistical analysis used: Data were analyzed using descriptive statistics including frequency and percentage distributions using Microsoft Office Excel (version 2019; Microsoft Corporation, Redmond, WA, USA). Categorical variables were expressed as frequencies and percentages, while continuous variable (age) was summarized using median and interquartile range. Associations between categorical variables were analyzed using Chi-square/Fisher's exact test, and continuous variables across groups were compared using Kruskal-Wallis test with Dunn's post hoc analysis. Statistical analysis was performed using Stata 18.0, with P < 0.05 considered statistically significant.

Results: A total of 246 patient records were analyzed, with Aramany-classified maxillary defects constituting the most common defect category (48.0%). Infections were the leading etiological factor (33.3%), followed by trauma (28.9%) and neoplasms (25.6%). Infection- and neoplasm-related defects showed a significant association with Aramany-type maxillary defects ( P = 0.001). Obturator prostheses were the most frequently delivered treatment modality (56.1%). A significant correlation was found between age and maxillofacial defects ( P = 0.04). Smoking (54%) and smokeless tobacco use (24%) were commonly associated risk factors.

Conclusions: Acquired maxillofacial defects constituted the majority of cases requiring prosthetic rehabilitation. Infection-related defects, particularly mucormycosis, represented a substantial proportion of cases during the study period, reflecting changing disease patterns observed in the post-coronavirus disease 2019 era. Older age groups demonstrated significantly higher frequencies of malignancy and mucormycosis-related defects. Standardized classification systems facilitated systematic documentation and communication of defect characteristics, while prosthetic rehabilitation was individualized according to the extent of tissue loss, anatomical involvement, and functional requirements. Obturator prostheses remained the most frequently utilized rehabilitation modality for maxillary defects.