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Customized protocol for psychological management of a patient with residual maxillofacial defects

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Original Article

Author Details : Poonam Prakash*, Rahul Bahri, SK Bhandari

Volume : 7, Issue : 4, Year : 2021

Article Page : 209-216

https://doi.org/10.18231/j.aprd.2021.041

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Abstract

Background: Maxillofacial surgeons and Prosthodontist deal with rehabilitation of defects of orofacial region but understanding the mental attitude of patients is often ignored or neglected. Success of any prosthesis relies on patient’s compliance and motivation to adjust and cope up with irreversible loss. Evaluation of psychological distress and management of the same is of utmost importance. Literature is deficit with an elaborate systematic classification system to evaluate the impact of maxillofacial defect on the psychological status of patients and role of therapy on improvement post-rehabilitation.
Aims & Objective: Am of this study is to propose a customized comprehensive protocol for evaluation of psychological status using ICD-11 classification system before and after maxillofacial prosthetic intervention and impact of psychological management tools on the same.
Materials and Methods: Ten patients with maxillofacial defects reporting for prosthetic rehabilitation were selected. Psychological evaluation tool, ICD-11 classification system was applied pre and post rehabilitation by two independent observers. Customized psychological management protocol was formulated and implemented to note the impact on overall improvement in psychological status of the patient.
Results: Patients with severe personality trait showed varied levels of improvement ranging from no change to mild. Five patients with moderate personality trait showed improvement and change in personality trait to mild on implementation of psychological tools. Statistical evaluation could not be done due to multitude of subjective variables.
Conclusion: ICD-11 can be used as a successful tool for psychological evaluation of patients. Necessary intervention at every level in form of family support, support groups, psychological therapeutic modalities and therapies can improve status of the patient. A well-structured management protocol helps in early recognition of psychological distress and systematic management of the same to improve clinical outcome of the rehabilitation procedure.
Clinical Implications: Patients with maxillofacial defects experience a progressive cycle of loss and grief. This diminishes their ability to adjust to stress and acceptability towards maxillofacial prosthetic rehabilitation procedure. Assessment of psychological alteration using a standardized classification system and utilization of therapeutic modalities to deal with the same helps in successful rehabilitation and restoration of patient in the society as a whole.
 

Keywords: Customized protocol, Psychological evaluation, maxillofacial, ICD­11

How to cite : Prakash P, Bahri R, Bhandari S, Customized protocol for psychological management of a patient with residual maxillofacial defects. IP Ann Prosthodont Restor Dent 2021;7(4):209-216

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