Aesthetic rehabilitation of a patient with an anterior maxillectomy defect, using an innovative single-step, single unit, plastic-based hollow obturator (original) (raw)
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A Novel Technique for Fabrication of Hollow Obturator for a Maxillary Defect: A Case Report
Journal of Nepalese Prosthodontic Society, 2022
Prosthodontic rehabilitation following aggressive infections and malignancies is challenging. Surgical intervention may lead to anatomical defects resulting in oro-antral communication that causes difficulty in mastication, deglutition, impaired speech and facial disfigurement. The role of a Prosthodontist in maxillary defects is to restore these defects with the fabrication of obturators. However, the extent of the obturator into these large defects necessitate bulkier, heavy prosthesis which would likely be nonretentive and uncomfortable for the patient. Hollow bulb obturators are fabricated to reduce the weight of these prostheses. The method of fabrication of hollow bulb obturators with lost salt technique in the maxillary defect is described in this case report.
Fabrication of a Hollow Obturator as a Single Unit for Management of Bilateral Subtotal Maxillectomy
Journal of Prosthodontics, 2012
Prosthetic rehabilitation with an obturator for a total or subtotal maxillectomy patient is a challenging task, as there are little or no residual maxillary structures to depend on for support, retention, and stability of the prosthesis. This clinical report describes the prosthodontic management of a patient operated on for a bilateral subtotal maxillectomy secondary to ameloblastoma of the palate with a closed hollow obturator. The processing technique described in this article to fabricate the hollow obturator is a variation of other well-known techniques. The variation comprises the use of a wax bolus to maintain a predictable internal dimension for a hollow obturator. This technique allows fabrication of a complete hollow obturator prosthesis as a single unit in heat-polymerized acrylic resin using a single-step flasking procedure.
A hollow definitive obturator fabrication technique for management of partial maxillectomy
The Journal of Advanced Prosthodontics, 2012
Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.
Technique of Fabrication of Definitive Hollow Obturator for Partial Maxillectomy Patient
International Journal of Prosthodontics & Restorative Dentistry, 2017
Aim: Closed hollow obturators are often fabricated to provide adequate retention, stability and comfort for the patient. Background: Rehabilitation of patient with maxillary obturator is the most common treatment option after maxillectomy. However, the heavy weight of obturator often leads to discomfort and problem in its retention. Case report: This article presents rehabilitation of a patient after the surgical removal of desmoplastic ameloblastoma. It employs a simple procedure to create a closed hollow obturator with uniform and adequate thickness of prosthesis wall. Conclusion: The technique offers advantage since it is easily fabricated with routinely used materials in a short time.
Journal of Nepalese Prosthodontic Society, 2018
Rehabilitation of patients with a palatal defect requires management of anatomical, functional, esthetics as well as psychological factors. A reduced denture-bearing area, increased inter arch space, and cantilever movement cause complex problems in these palatal defects. Solid obturator is heavy and continuous stresses on the remaining tissues jeopardizes the health, compromise the function of the prosthesis and affect patient comfort. Reducing the weight of the prosthesis by making it hollow prevents the cantilever movement thereby increasing retention, stability and brings improvement in speech by resonance effect. This clinical report describes the rehabilitation of young adult patient with total maxillectomy using maxillary hollow bulb obturator fabricated with lost salt technique.
Journal of Prosthodontics, 2011
The presence of oral cancer can necessitate the surgical removal of all or part of the maxilla, leaving the patient with a defect compromising the oral cavity's integrity and function. The immediate postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. This article describes a simple technique to fabricate an immediate surgical obturator by restoring the patient's original dentition and facial and palatal tissue form. An immediate obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement and thus may have a positive effect on the patient's psychology.
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.
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.
Fabricating a Hollow Obturator with Light-Cured Resin System
The Journal of Indian Prosthodontic Society, 2012
Tumor resection of a cancer lesion produces maxillary defects that can be easily restored with an obturator to close the defect area. Postsurgical maxillary defects predispose a patient to hypernasal speech, fluid leakage into the nasal cavity, and impaired masticatory function. Therefore, the primary aims of prosthetic rehabilitation in total and partial maxillectomy patients include: separation of oral and nasal cavities to allow adequate deglutition and articulation, possible support of orbital contents and support of soft tissue to restore mid-facial contours. A method of fabricating a simple hollow obturator for maxillectomy patients is described. The use of a relatively long-lasting light cure resin materials in making obturators allows stable, comfortable, and effective obturation. The hollow prosthesis is lightweight and sufficiently flexible to allow relatively simple placement in retentive undercut regions.