Implant-Supported Full Fixed Prostheses with a Removable Oro-Nasal Obturator for the Edentulous Maxilla with Palatal Fistula due to Surgical Procedures for Oral Cancer

Abstract

Open oro-nasal defects resulting after oral tumor resection need structural and functional rehabilitation using dental prostheses. Conventional removable prostheses have usually been indicated and performed for prosthodontics. When the patient has an edentulous maxilla, the unfavorable stability of the prosthesis will cause dysfunction of mastication and pronunciation. To achieve improvement of the impaired functional situation, implant-supported full fixed prostheses (IPSPs) for the edentulous maxilla with a removable obturator offer a reasonable solution. We present herein the case of a 70-year-old Japanese man who has presented with oro-nasal defect due to surgical procedures for oral cancer. He was treated with implant-supported full fixed prostheses in a conventional two-step procedure. After prosthesis treatment, a palatal obturator was set. The patient has shown no clinical or radiological evidence of failure as of 24 months after the end of treatment. Functional evaluation of mastication and pronunciation showed dramatic improvements. For a patient with an edentulous maxilla and palatal fistula, full-arch fixed prostheses supported by a combination of axially and non-axially positioned implants and a removable oro-nasal obturator, using the anterior alveolar bone, without bone transplantation or maxillary sinus elevation, could offer an effective, minimally invasive treatment alternative.

The Neutral Zone Approach with CAD‐CAM Record Bases

“…The modified Yamamoto method was used to evaluate the stability of the complete denture. 11 The patient was able to eat various foods effectively, without movement of the complete denture. To compare the positions of denture teeth arranged according to the neutral zone technique and the conventional technique, denture teeth were arranged on the CAD-CAM record bases using both methods.…”

“…The modified Yamamoto method was used to evaluate the stability of the complete denture 11 . The patient was able to eat various foods effectively, without movement of the complete denture.…”