Immediate and interim prosthodontic management of post-surgical maxillectomy patient using obturator prosthesis: A case report (original) (raw)
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Obturator prostheses following palatal resection: clinical cases
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2010
Malignant tumours of the upper gum and hard palate account for 1-5% of malignant neoplasms of the oral cavity; two thirds of the lesions which involve these areas are squamous cell carcinomas. Most of these carcinomas are diagnosed late, when they invade the underlying bone. The procedures of choice for removal are: alveolectomy, palatectomy, maxillectomy, which may be total or partial. Surgical reconstruction of the defect may be carried out using a wide range of microvascularized flaps: osteomuscolocutaneous of the internal iliac crest, an osteocutaneous flap of the fibula or scapula, fascia, or osteocutaneous radial flap, or a pedicled flap of temporal muscle. These flaps are supported by single or multiple obturator prostheses. Rehabilitation via palatal obturators is preferred in patients with a poor prognosis or in weak condition. Rehabilitation aims to: restore the separation between the oral and nasal cavities, enable the patient to swallow, maintain or provide mastication, ...
Goal of prosthodontics is rehabilitation of missing oral and extra oral structures with restoration of normal function of mastication, speech, swallowing, appearance etc. Malignancies are common in oral region, which are treated through surgical intervention. Surgical intervention creates anatomic defect which forms communication among the oral cavity, nasal cavity and maxillary sinus. In such cases it is very difficult for the patient to perform various normal functions like mastication, swallowing, and speaking etc. Prosthodontic rehabilitation with obturator prosthesis restores the missing structures and act as a barrier between the communications among the various cavities.
Rehabilitation of Maxillectomy Case Wi̇th Conventional Retained Obturator Prosthesis: A Case Report
Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 2018
Maxillary resection performed for removal of the tumor mass, leads to esthetic, phonetic, functional and important psychological problems for the patient. The primary aim of prosthetic rehabilitation is to close the maxillary defect and eliminate such problems by use of different bulb designs. An obturator is a treatment option for the defects after maxillary tumor surgery. In this article, rehabilitation with hollow bulb obturator prosthesis was explained for a patient subjected to maxillary resection because of tumor mass.
2016
Maxillary defects resulting from resection involving the maxilla pose unique surgical and prosthetic rehabilitation challenges. Such defects occur as a consequence of congenital malformations, trauma or surgical resection of tumors. Surgical reconstruction of large maxillary defect is seldom tried. The obturator is a prosthesis used to close maxillary defects to restore masticatory and phonetic functions. This clinical report describes prosthodontic management of a maxillectomy defect with obturator prosthesis.
Partial removable prosthesis in a patient with unilateral maxillectomy: A case report
2019
BACKGROUND AND AIM: Maxillofacial defects due to malignant or benign tumors or congenital defects often result in complications such as the impairment of facial aesthetic, mastication, speech, and swallowing. Remedy of these defects, especially in a dentate patient is an important challenge in prosthodontics. Maxillectomy can lead to severe anatomical changes following tumor resection and reconstruction such as decreasing skeletal soft tissue support. The present study describes an implant-supported obturator in a dentate patient. CASE REPORT: The present study indicates an obturator prosthesis in a 58-year-old patient with hemimaxillectomy (Aramany’s Class 1 defect) undergoing the treatment of mucoepidermoid carcinoma of the right palate. The research describes clinical and laboratory procedures in rehabilitation of a dentate patient with tooth, tissues, and implant-supported obturator. CONCLUSION: In dentate patients, the maxillectomy requires careful planning for removable partia...
Rehabilitation of maxillectomy defect with obturator prosthesis
The acquired defects of the palate are created commonly surgical intervention of benign or malignant neoplasms. The size and location of the defect influence the level of difficulty in prosthetic rehabilitation. Surgical intervention creates anatomic defect which forms communication among the oral cavity, nasal cavity and maxillary sinus. The goal of prosthodontist is to rehabilitate missing oral and extra oral structures with restoration of normal anatomic and physiologic function. Prosthetic rehabilitation with obturator restores the oral structures and also acts as barriers between communications among the cavities.
Management of a Maxillectomy Patient by Definitive Obturator
International Medical Journal (1994)
Background: Prosthetic and surgical procedure can be applied to rehabilitate acquired palatal defect. The obturator pros-thesis as a part of prosthetic management are used for separation of oral and nasal cavities to allow adequate deglutition and articulation, support for the soft tissue to restore the midfacial contour in palatal defect cases. Clinical presentation: This clinical report describes a prosthetic approach to the rehabilitation of acquired palatal defect with definitive obturator prosthesis and its outcome. We set the artificial teeth in unilateral group function occlusal scheme and finally process the denture. Conclusion: Rehabilitation with obturator prosthesis is functional, reliable/safe, and easy to build.
Palatal obturator prosthesis: a clinical case report
Cumhuriyet Dental Journal, 2018
This clinical report describes the details of a prosthodontic rehabilitation of an elderly patient who was diagnosed with mucoepidermoid carcinoma. The palatal defect has caused problems in phonetics and mastication. A previous obturator was made using conventional Polymethyl methacrylate (PMMA). This obturator has caused some discomfort due to food impaction and irritation of the fitting surface over the tissue defect areas. This had resulted in frequent erythema of the areas. Therefore, a new palatal obturator was made still using PMMA but with an addition of an indirect soft acrylic resin over the defect areas. The soft acrylic resin serves to reduce painful irritation of the obturator over the soft tissues around the defect areas. The review appointments up to 6 months revealed satisfactory results with no deterioration in the prosthesis. However, upon the followup appointment at 9 months, we could see some black stains on the fitting surface where the indirect soft acrylic resin was placed. Swabs were taken from the black area on the obturator and the related mucosa intraorally. The swabs were sent for a culture and sensitivity test to find microorganisms that caused the staining. The result confirmed that there were no microorganisms at both areas. This condition suggested that stain could occur on the surface of soft acrylic resin despite good oral hygiene practised by the patient. Further reviews will be made to monitor the condition.
Cancers Review
The maxillofacial patient experiences a unique alteration in the normal oral/craniofacial environment and functions, which are the results of congenital, traumatic or surgical insults. Maxillofacial Prosthetics aimed to attain the optimal functions, such as speech and swallowing, and normalcy of surrounding structure. The provision of surgical obturator is one step in achieving normalcy, as it allows covering the deficiencies/defects to regain optimal/suboptimal functions immediately after surgical resection. This paper provides an overview on the designing principles, goals and role of surgical obturator in rehabilitating maxillectomy cases.
Obturator Prosthesis for Edentulous Hemi-Maxillectomy patients: A Case Study
International Journal of Advances in Scientific Research and Engineering (ijasre), 2020
The maxillary tumors include various histological entities which are the subject of a very particular treatment. Clinical, radiological and anatomopathological criteria are used to determine the diagnosis. In spite of the evolution of reconstructive surgical techniques and the development of microsurgery, the conventional obturator prosthesis is still in use nowadays. In this context, it must restore the main functions of chewing, phonation and deglutition and give the patient a satisfactory aesthetic appearance.