Treatments that Transform
Drs. Vess and Walworth discuss a mandibular fibula free flap reconstruction plan.
the program has trained 38 fellows across the Air Force, Army and Navy, adapting to an increased need for maxillofacial prosthetics due to better survival rates from improved body armor — and restoring heroes’ quality of life in the process. At the same time, advances in weaponry have increased the number of warfighters sustaining soft- and hard-tissue injuries to the head and neck. May this legacy serve to inspire AGD members to embrace innovation in their own practices.
The Ethos: Returning Warfighters Whole to the Fight The Air Force Maxillofacial Prosthetics Fellowship Program embodies the motto: “Returning warfighters whole to the fight.” “Whole” signifies more than physical restoration — it’s about renewing confidence, dignity and purpose. Whether crafting an ocular prosthetic for a colonel who continues to serve or designing implants for a veteran reclaiming his ability to speak, the program ensures service members can return to their missions or civilian lives with resilience. For AGD members, this ethos inspires us to treat every patient holistically, addressing not just their dental needs but their human spirit, ensuring no one is left behind in their journey to healing.
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The fellowship equips specialists to restore both form and function through innovative treatments, collaborating with oral surgeons, oncologists and plastic surgeons to serve complex patient needs. Key interventions include: • Intraoral prostheses: Obturators for palatal defects, mandibular resection prostheses and implant-borne prostheses, critical for trauma or cancer recovery. • Extraoral prostheses: Lifelike silicone eyes, ears and noses, meticulously painted to match skin and eye tones, restoring confidence. • Dental oncology support: Radiation shields and rehabilitative devices to aid speech and swallowing for head and neck cancer patients. • Custom devices: Transparent pressure masks for burn patients, crafted using stereophotogrammetry (3D imaging) and 3D printing, alongside therapy aids and cleft palate molding devices. These treatments transcend esthetics, enabling patients to eat, speak and engage confidently. For AGD members, these innovations highlight dentistry’s role in holistic healing, inspiring us to explore advanced techniques in our practices.
Patient Stories: Heroes Reborn The program’s heart lies in its patients’ stories. One veteran, who was diagnosed with lower lip squamous cell carcinoma nearly a decade ago, sought dentures after extensive reconstruction. “I used to swing dance, but I don’t anymore,” he shared, describing years of limited eating and smiling due to an atrophic jaw and flap reconstruction. After months of planning with an ear, nose and throat doctor and oral surgery, specialists placed four mandibular and three zygomatic (cheekbone) implants. When he saw his interim prostheses, he teared up: “Doc, you did what others said couldn’t be done. I can’t wait to eat a steak.” His joy inspires AGD members to pursue creative solutions for complex cases.
Another active duty soldier lost much of his facial skin, including his nose and lips, due to an aberrant autoimmune reaction after being attacked with a knife. After spending months in the Army’s Burn Institute for Surgical Research rehabilitation clinic and being reconstructed with grafts, he received both a custom 3D-printed face mask and a silicone prosthesis for his nose and upper lip — both created from a 3D face model computed using a pre-injury video he provided. “I can go out in public without people seeing inside my body,” he said tearfully before traveling home to his family. Still serving, his resilience motivates us to connect patients with specialized care, such as through the American Academy of Maxillofacial Prosthetics (AAMP) or VA referrals.
Call to Gratitude The Air Force Maxillofacial Prosthetics Fellowship Program embodies service beyond the battlefield, restoring heroes one prosthesis at a time. This Veterans Day, let’s honor veterans by cultivating awareness of these specialized services. AGD members can make a difference by partnering with local VA clinics, referring complex cases to maxillofacial prosthodontists (find AAMP specialists at maxillofacialprosthetics.org) or simply expressing gratitude to veteran patients. By embracing the ethos of “returning warfighters whole to the fight,” we strengthen the bond between civilian and military dentistry, ensuring no hero faces the world alone. ♦ Note: The appearance of U.S. Department of Defense (DoD) visual information does not imply or constitute DoD endorsement. Col. Joshua A. Vess, USAF, DC, is program director of the Maxillofacial Prosthetics Fellowship Program at the Air Force Postgraduate Dental School, Joint Base San Antonio-Lackland, Texas. MAJ Patricia M. Walworth, USA, DC, is chief of maxillofacial prosthodontics at Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas. To comment on this article, email impact@agd.org.