# Psychological Well-Being and Oral Functional Recovery Following Combined Dental and Facial Reconstruction After Traumatic Jaw Loss: A Prospective Study

## TL;DR

This study shows that reconstructive dental and facial surgery improves both oral function and psychological well-being in patients who have experienced traumatic jaw loss.

## Contribution

The study provides new prospective evidence linking oral functional recovery with psychological well-being in traumatic jaw loss patients in a low- to middle-income setting.

## Key findings

- Psychological well-being and oral function significantly improved three and six months after reconstruction.
- Masticatory efficiency and patient-reported oral function were strong predictors of psychological well-being.
- Functional recovery explained 58% of the variance in psychological well-being scores.

## Abstract

Background

Traumatic jaw loss results in profound functional impairment and psychological distress, substantially affecting the quality of life of patients. While advances in dental and facial reconstruction have improved anatomical and functional outcomes, prospective evidence linking oral functional recovery with psychological well-being remains limited, particularly in low- and middle-income settings.

Objectives

The objectives of this study are (i) to prospectively evaluate changes in psychological well-being and oral functional recovery in patients following combined dental and facial reconstruction after traumatic jaw loss and (ii) to examine the association between functional outcomes and psychological well-being.

Methods

This prospective observational cohort study was conducted over 12 months at Abu Umaara Medical College, Ali Fatima Hospital in Lahore (Pakistan). Adult patients with traumatic mandibular and/or maxillary defects undergoing combined dental and facial reconstruction were enrolled using non-probability consecutive sampling. Psychological well-being was assessed using the World Health Organization-Five Well-Being Index (WHO-5). Oral functional recovery was evaluated through maximal interincisal mouth opening, masticatory efficiency, speech intelligibility, and patient-reported oral function. Assessments were performed preoperatively and at three and six months postoperatively. Repeated-measures analysis of variance (ANOVA), correlation analysis, and multivariable linear regression were applied, with p<0.05 considered statistically significant.

Results

Of the 132 eligible patients, 120 were enrolled and 112 completed the six-month follow-up. The mean age was 38.6±11.2 years, and 72.5% of the participants were men. Baseline WHO-5 scores indicated poor psychological well-being (34.8±9.6), alongside marked oral functional impairment. Significant improvements were observed at three and six months in WHO-5 scores and all functional parameters (all p<0.001). At six months, psychological well-being showed strong positive correlations with mouth opening (r=0.62), masticatory efficiency (r=0.68), speech intelligibility (r=0.55), and patient-reported oral function (r=0.71). Multivariable regression identified masticatory efficiency and patient-reported oral function as independent predictors of psychological well-being, explaining 58% of variance in WHO-5 scores.

Conclusion

Combined dental and facial reconstruction after traumatic jaw loss leads to significant improvements in oral function and psychological well-being. Functional recovery, particularly masticatory efficiency and perceived oral function, plays a pivotal role in psychological rehabilitation, underscoring the importance of integrated, patient-centered reconstructive care.