Scope of Practice - Maxillofacial Prosthetic Service
Maxillofacial Prosthetics defined by the current Glossary of Prosthodontic Terms – GPT 8 – as the branch of Prosthodontics concerned with the restoration and/or replacement of the stomatognathic (jaws) and craniofacial (facial) structures with prostheses that may or may not be removed on a regular or elective basis. The scope of services provided by the Maxillofacial Service at the University of Washington School of Dentistry since the 1950’s has focused its efforts to offer rehabilitation services for individuals who suffer anatomical compromise due to congenital (birth) disorders, trauma, and oral/facial malignancies. Patients in need of such rehabilitation services present a wide array of rehabilitation challenges associated with restoring normal appearance, improved function such as speech, mastication (chewing), and deglutition (swallowing) via the fabrication of prosthetic replacements for missing structures of the jaws and face. The contemporary approach to rehabilitation for individuals seeking such care, largely is being addressed with implant retained and/or supported prostheses. This approach to rehabilitation has revolutionized the ability to restore and normalize function in the face of very challenging anatomical compromise/loss. In most instances, the team approach to treatment that involves a head and neck surgeon, microvascular reconstructive surgeon, an oral and maxillofacial surgeon, and the maxillofacial prosthodontist. Commensurate with the management of oral and facial rehabilitation is the management of complications and side effects of adjunctive treatment such as radiation and chemotherapy, often provided as combined adjunctive therapy for management of malignancies in the head and neck. The use of adjunctive hyperbaric oxygen therapy is also commonly part of the management of patients who have had radiation treatment and are seeking implant rehabilitation.
Craniofacial implant retained facial prostheses, obturators, cleft palate speech aid prostheses, implant prostheses, and a wide array of unique and challenging rehabilitation efforts comprise this area of endeavor. As one patient so indicated, Maxillofacial Prosthetics is the “spare parts department” for a major tertiary care medical center making possible for patient’s so afflicted to be “made whole again”.
Jeffrey E. Rubenstein DMD, MS
Dr. Rubenstein is a Professor and Director of the Maxillofacial Prosthetic Service, University of Washington School of Dentistry in Seattle. His academic credentials include a BA from Rutgers College (1972), a DMD from Tufts University (1975), a GPR from Lancaster Cleft Palate Clinic (1976), and an M.S. & Certificate in Prosthodontics from MD Anderson Hospital and the University of Texas (1980). In 1980, he joined the faculty of Harvard School of Dental Medicine (HSDM) and, from 1983-89, in HSDM’s Department of Implant Dentistry. He is a Diplomate of the American Board of Prosthodontics, a Fellow of the American College of Prosthodontists, the Academy of Prosthodontics and the 2007 President and Fellow of the American Academy of Maxillofacial Prosthetics, Fellow and Past President of the Washington State Society of Prosthodontists, and an active member of the Academy of Osseiointegration. He lectures locally, nationally, and internationally with a focus on implant maxillofacial prosthodontic rehabilitation. He actively conducts clinical trials research and has published in periodic and text literature.