A custom-made replacement for part of the mouth, jaw or face, inside the mouth (such as an obturator) or on the face (ear, nose, eye).
May help with
Speaking, eating, swallowing and appearance after cancer surgery, trauma or a congenital defect.
What is involved
A clinical examination, impressions or scans, trial fittings and adjustments before the prosthesis is finished.
Aftercare
Daily cleaning, regular reviews as tissues change, and periodic adjustment or remaking.
Whether a prosthesis is suitable, and which kind, depends on each person and is assessed at consultation.
What is a maxillofacial prosthesis?
A maxillofacial prosthesis is a custom-made replacement for part of the mouth, jaw or face. It may help with speaking, eating, swallowing and appearance where tissue has been lost or is missing. Whether a prosthesis is suitable, and which kind, depends on each person's anatomy, medical history and treatment plan. This is assessed at a clinical consultation.
Maxillofacial prosthetics is a specialised branch of prosthodontics. Where surgery alone cannot rebuild what has been lost, or where a patient is not suited to further reconstruction, a carefully made prosthesis can restore function and appearance.
Who may need one
After cancer surgery to the mouth, jaws, sinuses or face, for example after a maxillectomy or mandibulectomy. See post-cancer rehabilitation.
After trauma that has caused loss of teeth, bone or facial tissue.
Congenital defects such as cleft palate or an underdeveloped ear.
Is this for me?
Could a maxillofacial prosthesis help me?
May suit you if
Part of your palate, jaw or face has been removed during cancer surgery
You have lost teeth, bone or facial tissue through trauma
You were born with a defect such as a cleft palate or an underdeveloped ear
Food or liquid escapes into the nose, or speech has become nasal, after palate surgery
Discuss first if
Further surgical reconstruction is planned or being considered
You have had, or will have, radiotherapy to the area
Cleaning and handling a prosthesis each day may be difficult
Suitability and results vary for each person and are discussed at consultation, together with your treating team.
Types of maxillofacial prostheses
Prostheses are broadly intraoral (inside the mouth, such as obturators for palatal defects and mandibular or guide-flange prostheses) or extraoral (on the face, such as ear, nose, eye/orbital and other facial prostheses). The sections below are general information about each type; which option is suitable is discussed at consultation.
Intraoral obturators after maxillectomy
A maxillectomy removes part of the upper jaw (maxilla), often including part of the palate and some teeth. This can leave an opening between the mouth and the nose or sinus. Without a prosthesis, patients may notice:
food and liquids escaping into the nose while eating or drinking
nasal, hard-to-understand speech
difficulty chewing and a change in facial support
Front cross-section of the mid-face: normal anatomy, the opening left by a maxillectomy, and how an obturator closes it.
An obturator is a removable prosthesis that closes this opening, separates the mouth from the nasal cavity and can carry replacement teeth. It is usually made in stages:
Surgical (immediate) obturatorPrepared before the operation from impressions or scans, and placed by the surgical team at the end of surgery. It supports the surgical packing and helps the patient speak and swallow from the early days.
Interim obturatorUsed during healing, often for several months. Because the tissues shrink and change, it is relined and adjusted regularly to keep the seal comfortable and effective.
Definitive obturatorMade once healing has settled and the area is stable. It is designed for long-term comfort, retention, speech and appearance, using the remaining teeth and, in selected cases, dental implants.
Obturator stages seen from below: a surgical plate, an interim obturator adjusted during healing, and a definitive obturator with replacement teeth.
Prostheses after mandibular resection
Surgery on the lower jaw (mandibulectomy) can change how the jaw moves and how the upper and lower teeth meet. When part of the jaw is removed without immediate bony reconstruction, the remaining jaw often drifts towards the operated side. Depending on the situation, rehabilitation may include:
Guidance therapy: jaw exercises and a guide-flange or guiding-ramp prosthesis that helps the jaw close in a more functional position
Removable partial dentures designed around the altered anatomy
Implant-supported prostheses on reconstructed jaws (for example after a fibula free-flap reconstruction), where bone, soft tissue and radiation history allow
After part of the lower jaw is removed, the jaw can drift toward the resected side. A guide flange helps it close in position.Side view of a lower jaw rebuilt with a fibula bone graft, with implants in the graft supporting a prosthesis.Facial prostheses replace the eye and eyelid area (orbital), the ear (auricular) or the nose (nasal).
Orbital and ocular (eye) prostheses
An ocular prosthesis (artificial eye) is a custom acrylic shell that fits into the eye socket after the eye has been removed (enucleation or evisceration). It is hand-painted to match the other eye and restores the appearance of the eye and eyelids.
An orbital prosthesis is used when the eye and surrounding tissues of the eye socket have been removed (orbital exenteration). It is usually made from medical-grade silicone, sculpted to match the other side of the face, including eyelids, and is commonly retained with adhesive, spectacles or craniofacial implants.
Auricular (ear) prostheses
An ear may be lost to cancer surgery or trauma, or be underdeveloped from birth (microtia). An auricular prosthesis is sculpted to mirror the opposite ear and colour-matched in silicone. It can be held with skin adhesive or, for more secure and convenient retention, with implants placed in the bone behind the ear.
Nasal (nose) prostheses
After partial or total removal of the nose (rhinectomy), a nasal prosthesis can restore the appearance of the nose and protect the nasal passages. It is made in silicone, matched to the patient's skin tone, and retained with adhesive, spectacles or implants. Sometimes it is combined with an intraoral obturator where the palate is also involved.
Implant-retained facial prostheses
Craniofacial implants are small titanium implants placed in the bone around a facial defect. The prosthesis attaches to them with magnets or a bar-and-clip system, so it sits in exactly the same position every time and does not depend on adhesives. Benefits can include easier daily placement, better security and longer-lasting prosthesis margins.
Cross-section of an implant-retained ear prosthesis: implants in the bone, abutments through the skin, and a bar with clips holding the silicone ear.
Not every patient is suitable. Bone quality and quantity, previous radiotherapy, general health, and the ability to keep the area clean all matter. Implants in irradiated bone need particularly careful planning with the oncology team.
How treatment is planned
Planning usually involves a clinical examination, impressions or scans, trial fittings and adjustments before the prosthesis is finished. The main steps are shown below.
The main steps in making a custom maxillofacial prosthesis.
Living with a prosthesis
Clean the prosthesis and the tissues daily as instructed.
Silicone gradually changes colour and wears, especially with sunlight, so facial prostheses need remaking from time to time.
Tissues can change after surgery and radiotherapy, so regular reviews keep the fit comfortable.
Report any soreness, bleeding, swelling or non-healing area promptly.
Living with a prosthesis
Prosthesis care checklist
Clean the prosthesis and the tissues daily as instructed
Clean around any implant abutments on the skin or in the mouth as shown
Use only the adhesive and remover recommended for your prosthesis
Store the prosthesis clean and dry in its case when it is not worn
Protect silicone prostheses from long sun exposure and heat
Do not trim, glue or repair the prosthesis yourself
Report any soreness, bleeding, swelling or non-healing area promptly
Keep review appointments; tissues change and silicone ages over time
Follow the specific care instructions given for your prosthesis.
Working with your surgical and oncology team
Treatment is planned as part of a team with the head and neck surgeon, oncologist, radiation oncologist, speech and swallowing therapist and the patient's own dentist. Doctors can find referral details on the page for referring clinicians.
Suitability and results vary for each person and are discussed honestly at consultation.
Appointments
Book a consultation with Dr. Sheth
Every case is different. A consultation starts with an examination and the necessary records, and options are explained before any decision is made. Bring your reports and scans.
