Awareness and knowledge among medical undegraduates regarding maxillofacial defects and its rehabilitation

INTRODUCTION

An Individual’s face has a unique role in social and emotional expression and communication, and above all, it is a reflection of that person as correctly expressed in Saint Jerome’s saying “the face is the mirror of mind.”^[1]

Maxillofacial defects are common outcomes seen after a major trauma, congenital deformities, destruction of tissues due to infectious or autoimmune processes, and complications of therapy (e.g., osteoradionecrosis). These defects often need reconstruction for a person to regain his/her lost confidence and identity. For this purpose, reconstructive surgery is considered the primary treatment of choice in such cases, although not all defects are surgically treated and have to be corrected with the help of prosthesis.^[2]

The choice of reconstructive procedure depends on several factors such as size, localization of defects, loss of important anatomic structures, and general weakness of the patient.^[3]

Maxillofacial restoration is a theme that involves 2 important branches, named as craniomaxillofacial surgery and prosthodontics, that are concerned with utilitarian and ornamental stomatognathic restoration.^[4]

Maxillofacial defects lead to psychological suffering as well as a debilitating effect on the patient’s appearance and thus need to be corrected.^[5] Among other things, the patient’s abilities are also limited or altered, such as speaking, listening, and ability to see. He or she also suffers mental stress, with looks serving as the main trigger. Thus, correct diagnosis and treatment strategy are very important for the effective rehabilitation of the patient.

Maxillofacial abnormalities must be treated with meticulous diagnosis and collaboration among all treatment providers so the patients who have such defects should be properly channeled to the specialists by their doctors for timely rehabilitation.^[6]

The dentists or doctors who are being consulted need to have a fundamental knowledge of maxillofacial surgery faults and the fields of expertise involved in the remedies for them. A scientifically good, supervised undergraduate education in the investigation, therapy options, and fundamental treatment planning is unquestionably a top requirement given the number of and the consequent Economic and health relevance of craniofacial trauma and cancer consultations.^[7]

Due to patients’ growing awareness of their physical appearance, dentistry in the 21^st century focuses mostly on esthetics and reconstruction, and thus all doctors should be aware of the specialties for properly streamlining the patients in need.^[8]

MATERIAL AND METHODS

This study is a questionnaire-based survey which was designed to evaluate the awareness and knowledge among dental and medical undergraduate students.

Data was collected through a survey questionnaire with 15 questions that were filled through an online survey link. This study was approved by the Institutional Ethics Committee of VSPM Dental College, Nagpur. Overall 300 participants took part in a survey. The data were collected and statistically analyzed.

RESULTS

The study concluded that maximum undergraduate students along with interns irrespective of the gender of VSPM Dental College and Research Center and NKP Salve Institute of Medical Science, were aware of maxillofacial defects, though there were some who lacked the knowledge. The results are depicted in Figures 1-14 and Table 1 depicts the type of participants involved in the study and Table 2 represents results of the questionnaire used for the study.

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Figure 1:

Do you know about maxillofacial defects?

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Figure 2:

Have you ever seen a clinical case of maxillofacial defect?

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Figure 3:

Name of college.

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Figure 4:

Are you aware about various treatment modalities for maxillofacial defects rehabilitation?

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Figure 5:

Do you know the material used to take impression of maxillofacial defects?

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Figure 6:

The most common cause for maxillofacial defect?

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Figure 7:

If yes, which of the following materials are used?

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Figure 8:

Who would you refer for maxillofacial rehabilitation?

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Figure 9:

Do you know the material used to make the maxillofacial prosthesis?

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Figure 10:

If yes, then which of the following materials are used?

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Figure 11:

Awareness of mean cost that patient has to face for this type of prosthesis?

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Figure 12:

What is the role of aesthetics in maxillofacial prosthesis?

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Figure 13:

Which recent advances in maxillofacial defect rehabilitation are you aware of?

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Figure 14:

Awareness about a fact that prosthesis better supported and retained with implants?

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The students who had a certain amount of knowledge regarding maxillofacial defects and their rehabilitation were observed to have awareness about types of maxillofacial defects and were aware of referring patients with maxillofacial defects for rehabilitation to a prosthodontist. It was also found that awareness regarding maxillofacial prosthesis was there, specifically about ear and eye prosthesis as compared to others. In terms of material knowledge, most of the undergraduates were aware that the material of choice for taking the impression of the prosthesis is alginate. Many of the undergraduates are aware that prosthesis can be better supported and retained with the help of implants. The undergraduates were apprised about the mean charges that a patient has to face such type of prosthesis. Maximum undergraduates are aware of 3D printing in recent advances. Although most students were aware of maxillofacial defects and its treatment protocols, it was observed that the undergraduate students of VSPM Dental College were more informed about it than the students of NKP Salve Institute of Medical Sciences, which indicated a need for creating awareness in all medical institutes.

It was also found that most of the undergraduates lacked awareness about the common cause of maxillofacial defects and were also not aware of the treatment modalities for maxillofacial defects. It was also observed that they did not have knowledge regarding the role of esthetics in maxillofacial prosthesis.

DISCUSSION

Patients with maxillofacial defect problems might benefit from extended appliances such as finger prostheses, vaginal stents, and other things thanks to maxillofacial prosthodontics, which aims to restore form and function. Maxillofacial prosthodontists collaborate with other specialists on interdisciplinary teams.

They collaborate closely with speech therapists, occupational therapists, and physiotherapists, as well as oral surgeons, cosmetic surgeons, ear, nose, and throat surgeons, eye specialists, general surgeons, cancer specialists, orthopedic surgeons, obstetricians, and pediatrists.

Few people in the general public and among medical professionals are aware of the capabilities and range of a maxillofacial prosthodontist. The practitioners have some knowledge of such a method of therapy and that it is under the prosthodontist’s scope of study. Due to ignorance, patients with maxillofacial abnormalities are improperly advised and directed to a maxillofacial prosthodontist for rehabilitation. The dentofacial and craniofacial area plays an important part in looks because it shows an individual’s identity. Every change, even small, makes a drastic change in the outside appearance, and it harms the patient’s mental health.^[9]

While craniofacial and dentofacial defects are classified into two types, that is, congenital and acquired malformations. The cause exists the same, and it is the duty of the treating dentist to identify the cause and develop an effective treatment plan.^[10]

In this study, a population of 136 undergraduates out of 300 undergraduates (44.9%) chose acquired defects as the most common cause of maxillofacial defects. While in the study conducted by Aksoy et al. is the opposite, stating that trauma is the most common cause of maxillofacial defects.^[11]

In this study, it was discovered that undergraduate students had a high knowledge of maxillofacial deformities because the maximum number of students were aware of these limitations have numerous causes and need for an integrative way. It was consistent with research done by Alani et al. on maxillofacial surgeons’ attitudes toward the treatment and rehabilitation of oral cancer patients.^[12]

In this study, the majority of students were aware of prosthodontists’ role in the rehabilitation of craniofacial abnormalities. However, in this study, undergraduates have more awareness compared to research done by Vadepally et al., Only 3% of physicians were found to choose oral and maxillofacial surgery when referring cases of cleft lip and palate and related craniofacial syndromes.^[13]

In this study, among respondents, 45.5% said that the most crucial element of esthetic rehabilitation is a lifelike prosthesis. This study was not that much in correlation with research done by Hatamleh et al., where 95.4% of the patients were satisfied with all satisfaction statements presented, proving that their prosthesis was comfortable to wear, looked realistic, and met their belief (i.e., facial look), thus boosting their confidence.^[14]

In this study, the majority of the students in this study were not aware of the most recent treatment planning techniques for the rehabilitation of craniofacial abnormalities. Contrary research revealed this to a similar research done by Sharma et al., on U.G. dental students of Nepal regarding dental implants, where most of the respondents agreed that they were not provided with sufficient information about implant procedures during their U.G. program.^[15]

CONCLUSION

Undergraduates have an understanding, point of view, and awareness regarding dentofacial and craniofacial defects and its rehabilitation. The most recent advances must be delivered, and students must have enough information to advise and direct a patient.