Rehabilitation of oncology patients with hard palate defects part 2: principles of obturator design

Abstract

The first part of this series on the conventional rehabilitation of oncology patients with hard palate defects discussed the dental challenges posed by oncology patients and the surgical/restorative planning interface for conventional dental rehabilitation. This article will describe Aramany's classification of hard palate defects, Brown's classification of palatal defects and focus on the basic principles of obturator design which need to be appreciated when prosthetically rehabilitating a patient with a hard palate defect. Clinical relevance statementA good understanding of basic removable prosthodontic theory relating to denture design, dental materials science and head and neck anatomy is an absolute prerequisite when designing an obturator for a patient. Learning ObjectiveThis article will describe: (a) how hard palate defects can be classified and (b) the basic principles of obturator design which need to be appreciated when rehabilitating a patient with a maxillectomy defect.

A Palatal Speech Bulb—A Case Study

“…This case study describes the construction, and subsequent refinement, of a palatal speech bulb prosthesis following surgery for neoplastic disease. When an obturator is the preferred oral rehabilitation, its design is dependent upon the size and position of the defect as well as the residual anatomy that can provide support and retention for the prosthesis [7].…”

An implant-retained obturator – a case study

“…6 When an obturator is considered the more appropriate oral rehabilitation, its design is dependent upon the patient's defect and residual denture bearing anatomy. 7 Larger palatal defects may make provision of an obturator more challenging due to tooth loss, limited bony support and the need to restore large areas of oral and/or facial soft tissues. For some patients, other than providing dental implants, the only option to achieve good retention is to fully engage the available soft-tissue undercuts found within the defect space and on the non-resected site.…”

The Ufi Gel P (VOCO) aplication for the correction of the resection prosthesis in an orthopaedic rehabilitation of a patient with a postoperative upper jaw defect of oncological origin. Clinical case

“…Внутрішнє прилягання протеза практично не порушилось. Відомо, що основними проблемами при протезуванні пацієнтів після резекції верхньої щелепи є незворотні зміни кісткової структури черепа та наявність сполучення між порожниною рота й носовою порожниною і спричинена цим висока мікробна адгезія до базису протеза, а також вертикальне зміщення протеза [2,3]. Періодично пацієнт здійснював антисептичну обробку слизових оболонок, оскільки за період лікування він набув антибіотикорезистентність.…”