Definitive Obturator Fabrication for Partial Maxillectomy Patient

Abstract

Maxillectomy defects can result in oroantral communication that causes difficulty in mastication and deglutition, impaired speech, and facial disfigurement. The prosthodontist plays an important role in the rehabilitation of such defects with obturators. This paper describes a clinical report of fabricating a definitive obturator with a cast metal framework using a single flask and one-time processing method for an acquired maxillary defect. A tripodal design was selected for this case. Rest was placed on the premolars and molars of both quadrants of the maxilla. Complete palate as the major connector was designed to ensure maximum distribution of the functional load to the tissue. Indirect retainer was planned on the right first premolar. Direct retention was provided by the I-bar clasp placed on the left first premolar, circumferential clasp on the right first premolar, and embrasure clasp between the right first and second molars. Thus, this definitive prosthesis rehabilitated the patient by providing better masticatory efficiency, improving the clarity of speech and quality of life of the patient.

Palatal Obturator after Maxillectomy following Squamous Cell Carcinoma

“…Its plastic nature allowed us to mold the undercuts of the maxillary defect during the insertion of the custom tray. Its elasticity after setting allowed us to disinsert it without tearing or detachment of the impression [ 13 ].…”

Rehabilitation of a Patient with Partial Maxillectomy: A Case Report

“…The basic principles of the design of removable partial dentures should be reviewed when designing the framework for an obturator. Major connectors should be rigid [17], occlusal rests should direct occlusal forces along the long axis of the teeth, guide planes should be designed to facilitate stability, and direct retainers should provide bracing and retention. All these elements must respect the physiological limits of the periodontal ligament of the abutment teeth [18,12].…”

Patient Satisfaction with Flexible Acrylic Compared to Conventional Polymethylmethacrylate Obturators (Randomized, Clinical Study)

“…Patients suddenly find themselves unable to perform the daily physiological functions they did with ease, as well as having to deal with the immediate change in appearance and facial contour following the surgery. Prosthetic rehabilitation is thus of great value to restore, as much as possible, the compromised function and appearance (8,10) . PMMA has been used for years as the material of choice for obturator construction, however, it is not ideal from all aspects.…”

“…"Health-related quality of life" (HRQOL) and Treatment satisfaction have recently been recognized as patient-based outcome measures in context of prosthetic rehabilitation of patients treated from head and neck cancer (4)(5)(6)(7)(8) . The aim of this study was to compare maxillectomy patient satisfaction when using obturators constructed using PMMA and Flexible acrylic, which has not been reported previously in literature, to the best of our knowledge.…”