Oral Health-Related Quality of Life among Post-Surgical Maxillofacial Prosthetic Patients: A Cross-Sectional Analysis

Abstract

Objectives: To assess oral health-related quality of life (OHRQoL) among post-surgical maxillofacial prosthetic patients attending a tertiary care dental hospital in Islamabad, and to examine its association with demographic and prosthetic variables.

Methods: This cross-sectional analytical study was conducted from January 2025 to September 2025 at the School of Dentistry, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Using non-probability consecutive sampling, 150 post-surgical patients with surgically acquired maxillofacial defects rehabilitated with a definitive prosthesis for at least three months were enrolled. OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14), administered by face-to-face clinical interview. Internal consistency was evaluated using Cronbach’s alpha, and the normality of cumulative scores was assessed with the Shapiro–Wilk test. Between-group comparisons used independent-samples t-tests and one-way analysis of variance (ANOVA) with Tukey HSD post-hoc testing; effect sizes were expressed as Cohen’s d and eta-squared (η²). Analyses were performed in IBM SPSS Statistics version 26, with significance set at p < 0.05.

Results: The mean age of participants was 48.6 ± 12.4 years, with a male-to-female ratio of 1.88:1. The commonest etiology was surgical resection for oral squamous cell carcinoma (78.0%). The mean cumulative OHIP-14 score was 18.42 ± 6.10. Functional Limitation (3.12 ± 0.8) and Psychological Discomfort (2.85 ± 0.9) were the most affected domains. Within the maxillary-defect subgroup (n = 110), users of modified lightweight hollow-bulb obturators (n = 65) reported lower OHIP-14 scores (14.22 ± 3.40) than users of conventional solid-bulb prostheses (n = 45; 21.65 ± 5.10; mean difference 7.43, 95% CI 5.82–9.04; t = 9.12, p < 0.001; Cohen’s d = 1.71). Across the full sample, OHIP-14 scores differed by duration of prosthesis use (one-way ANOVA, p = 0.024, η² = 0.053), with long-term users (> 12 months; 15.10 ± 4.30) scoring lower than early users (3–6 months; 21.80 ± 5.90; Tukey HSD p = 0.018). Cronbach’s alpha for the instrument was 0.86.

Conclusions: Among prosthetically rehabilitated patients, the social and psychological domains were comparatively less impaired, whereas functional limitation remained prominent. Lower OHIP-14 scores were associated with the use of lightweight hollow-bulb maxillary obturators and with longer duration of prosthesis use. As an observational study, these findings describe associations rather than causal relationships.