Use of a Removable Silicone Bung for Increased Seal and Retention of an Obturator in the Prosthetic Rehabilitation of a Unilateral Maxillary Defect: A Clinical Case Report (original) (raw)
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Journal of International Oral Health, 2016
The essence in cancer care has shifted from mere "survival" to "rehabilitation," which aims to improve multiple impairments and quality of life. Head and neck cancers constitute one of the most devastating forms of cancer resulting in maxillofacial defects. Rehabilitation of acquired maxillofacial defects is accomplished either by surgical or prosthodontic rehabilitation. The goal of prosthetic rehabilitation is to obturate the defect, allowing for optimum esthetics and function. However, this has remained as a challenging process due to the lack of adequate retention, stability, and support of the prosthesis. This study presents a simplified approach to rehabilitate an extensive maxillectomy defect secondary to surgical resection in a patient with the limited oral opening. The patient had undergone left hemimaxillectomy for squamous cell carcinoma of the left alveolus 7 days back. The patient did not have a surgical obturator and required prosthesis to restore t...
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.
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...
Clinical and Experimental Dental Research, 2020
Background: There is insufficient evidence for the efficacy of silicone soft reliner on the obturator prosthesis after maxillectomy for oral malignant tumors. Objective: To verify the efficacy of silicone soft reliner on the obturator prosthesis after maxillectomy, by evaluating masticatory performance and quality of life (QoL). Methods: This was a single-arm prospective interventional study, verifying the efficacy of silicone soft reliner (GC RELINE II ®) on the maxillary obturator prosthesis. Data were obtained from a comparison of the endpoints after 14 days of continuous use of acrylic and silicone soft-lined prostheses. The primary endpoint was masticatory performance. The secondary endpoints were occlusal performance and oral health-related QoL (OHRQoL). The masticatory performance, occlusal performance, and OHRQoL were assessed by glucose concentration, maximum bite force, and the Japanese version of Oral Health Impact Profile (OHIP-J49), respectively. Results: This study included five patients (two males, three females), aged between 71 and 88 years, with a median of 74 years. The median of glucose concentration indicated a statistically significant improvement between the acrylic resin (99.6 mg/dL) and silicone soft reliner (126.0 mg/dL) obturator prosthesis (p = .043). There was no significant difference in the median of maximum bite force between the acrylic resin (302.0 N) and silicone soft reliner (250.0 N) obturator prosthesis (p = .893). Functional limitations domain of the OHIP-J49 indicated a statistically significant improvement between the acrylic resin and silicone soft reliner obturator prosthesis (p = .043).
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.
A Simple Method of Fabricating an Interim Obturator for a Maxillectomy Defect: A Case Report
, 2023
The objective of interim obturator placement is to restore and maintain oral function to a reasonable level during the postoperative period. A 65 years old female patient of Aramany Class I maxillary defect was prosthetically rehabilitated by an Interim obturator. The patient was undergone a partial maxillectomy due to removal of sino-nasal carcinoma in the right side of the hard palate. Reasonable amount of retention, stability and support were found on subsequent recalls. Slight margin gap and lack of peripheral seal at the defect side was noted. The interim obturator restores mastication, swallowing, articulation and intelligibility of speech and the contour of the mid face. Rehabilitation with interim obturator prosthesis was functional, reliable, and has a low level of invasiveness. Interim obturator makes a prosthodontist way easy, to fabricate definitive obturator for the maxillary defect patient.
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.
Management of maxillary defect via obturator: A case report with review of literature
Turkish Journal of Physiotherapy and Rehabilitation, 2021
Fatality of maxillofacial structures brings about an inconsolable physical and psychological agony to a person. To plan and execute rehabilitation of such forlorn patients is the most challenging task of a prosthodontist since it demands both intellectual as well as derwent technical knowledge. Prosthodontic management involves the use of a prosthesis known as obturator prosthesis. This obturator prosthesis can be of different shape and size depending upon the extent of defect or lesion. This paper highlights different clinical steps and related review for the management of maxillary defect via oburator. The maxillary defect of an oro-nasal fistula was clinically detected in middle aged male patient, which was managed by giving an obturator. The procedure constitutes of fabricating an acrylic plate on the palate with missing teeth. Obturator placement to manage the defect yielded very satisfactory results in restoration of both form and function. The management of such patients with maxillofacial disorders such as congenital or acquired palatal defects, tumors in the maxillary region which ultimately before or after treatment leads to the communication between oral and nasal cavity or maxillary sinus, leading to facial disfigurement affecting esthetics as well as life of patient. These defects can be of any shape, size, and form and can extend to nasal cavity, orbital cavity or even brain. These problems make it tough and costly to treat surgically. Thus very economical way to rehabilitate is the use of an obturator. In simple words it is an acrylic plate which covers the defect and act as a barrier between two cavities.
IOSR Journals , 2019
Malignant conditions involving the maxilla or mandible are usually treated with surgical resection. To prevent the relapse, substantial surgical intervention might be done; leaving the patient with anatomical defects. In this case series, we have evaluated the different designs and techniques for the fabrication of obturator prosthesis used for the rehabilitation of maxillofacial defects. We have rehabilitated the defects with interim and definitive prosthesis according to the requirement of an individual cases using magnet retained, stud retained and microwave polymerized hollow bulb obturators for definitive prosthesis whereas microwave and heat polymerized for interim prosthesis.Clinician should be able to select the best suitable technique depending on the cases, for effective rehabilitation of the defect thereby improving the quality of life.
International Dental Journal of Student's Research, 2022
This clinical report describes a comprehensive prosthodontic treatment of a young patient diagnosed with squamous cell carcinoma in hard palate. The treatment procedures included surgical removal of the tumor, immediate surgical plate and interim obturator. The surgical plate and interim prosthesis were fabricated using conventional polymethyl methacrylate resin material with retention derived from wrought wire clasps to the remaining natural teeth. The follow-up system revealed satisfactory results with no deterioration in the prosthesis.