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Arigbede, A. O., O. O. Dosumu, O. P. Shaba, and T. A. Esan. "Evaluation of Speech in Patients with Partial Surgically Acquired Defects: Pre and Post Prosthetic Obturation." Journal of Contemporary Dental Practice 7, no. 1 (2006): 89–96. http://dx.doi.org/10.5005/jcdp-7-1-89.
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Abstract Aim Maxillectomy often results in a high level of morbidity with significant psychological and functional implications for the patient. Such disabilities include inability to masticate, deglutition, and speech disturbance. Unfortunately, little is known about the nature of the speech disturbance and the influence of the class of surgical defects in this group of patients. The aims of the present study were to assess the effectiveness of the maxillary obturator as a speech rehabilitation aid and to examine the influence of the classes of surgical defects on speech intelligibility (SI). Materials and Methods Twelve patients aged between 18 and 60 years with surgically acquired partial maxillary defects were included in this study. The patients were given immediate surgical obturators six to ten days after surgery, which were then converted to interim obturators by relining with tissue conditioner. Interim prostheses were used for two to three months until healing and resorption were found satisfactory after which the definitive obturators were fabricated. The SI test described by Plank et al.1 and Wheeler et al.8 was employed in this study. There were significant improvements in the mean SI score from 59.8% without prosthetic obturation, to 89.2% following interim obturation, and 94.7% following definitive obturation (p<0.005). Nine patients (75%) had class I surgical defects, two patients (16.67%) had class II defects, while only one patient (8.33%) had a class VI surgical defect. None of the patients had class III, IV, or class V surgical defects. There was an improvement in the SI score from class I to class VI without obturation, after insertion of interim obturator, and after insertion of the definitive obturator. Conclusion Results support the widely held view that the maxillary obturator is a useful speech rehabilitation aid. It also shows immediate, interim, and definitive obturators are all important in the speech rehabilitation of patients with surgically acquired maxillary defects. Moreover SI is affected by the class of defect. Citation Arigbede AO, Dosumu OO, Shaba OP, Esan TA. Evaluation of Speech in Patients with Partial Surgically Acquired Defects: Pre and Post Prosthetic Obturation. J Contemp Dent Pract 2006 February;(7) 1:089-096.
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Sharma, Vineet, Jyoti Paliwal, Balwant Singh Gurjar, and Kamal Kumar Meena. "Prosthetic management of acquired dentate maxillectomy defects: A clinical case series." Acta Marisiensis - Seria Medica 68, no. 2 (2022): 72–80. http://dx.doi.org/10.2478/amma-2022-0009.
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Abstract Acquired maxillectomy defects produce hypernasal speech, food, and liquid regurgitation into the nasal cavity, impaired deglutition and mastication, and cosmetic deformity. Furthermore, patients with acquired maxillary defects face psychosocial stigma, which has a negative impact on their quality of life. Prosthetic rehabilitation of such defects is required for stomatognathic system restoration and oroantral communication obturation. This case series discusses the fabrication of surgical, interim, and definitive obturator prostheses to restore the acquired dentate maxillectomy defects of three cancer patients. All patients had their treatment in the prosthodontics department of the RUHS College of Dental Sciences. The surgical obturator prosthesis was made before surgery, whereas the interim and definitive obturators were made one month and six months after surgery, respectively. The surgical obturator formed a shield between the surgical pack and the oral cavity. After the surgical obturator and packing were removed, an interim obturator was inserted for three to six months to allow the surgical site to heal. After the surgical site had healed, the fabrication of the definitive obturator began. Prosthetic rehabilitation with obturator prostheses sealed the acquired tissue defects of the palate and restored swallowing, speaking, chewing capacity, and cosmetic value, as well as significantly improved the quality of life of these patients.
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Parab, Manjita M. "Technique of Fabrication of Definitive Hollow Obturator for Partial Maxillectomy Patient." International Journal of Prosthodontics and Restorative Dentistry 7, no. 1 (2017): 38–41. http://dx.doi.org/10.5005/jp-journals-10019-1174.
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ABSTRACT 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. How to cite this article Parab MM, Aras MA, Chitre V. Technique of Fabrication of Definitive Hollow Obturator for Partial Maxillectomy Patient. Int J Prosthodont Restor Dent 2017;7(1):38-41.
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Karim, Abd. "Definitive obturator rehabilitation on the maxilla defect post-tumor surgery." Indonesian Journal of Prosthodontics 3, no. 2 (2022): 101–4. http://dx.doi.org/10.46934/ijp.v3i2.130.
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Background: Obturator is a prosthesis to replace tissue lost post tumor surgery in the maxilla called maxillectomy. Obturator is made of acrylic and consists of surgery, intermediate, and definitive obturator. Definitive obturator is made using Hollow bulb technique to be light and stable when used. In this case, a definitive obturator was made for a patient using intermediate obturator. Objectives: To inform that obturator can rehabilitate maxillary defect to restore the patient’s mastication, digestive, phonetic, aesthetic and psyche functions. Case report: A 28-year-old man came for postoperative cleft management. Diagnosis is Post OP Hemi maxillectomy Dextra. The procedure begins with impression to obtain study model and the making of individual tray. The next visit is grinding the remaining teeth for occlusal rest placement. Double impression is done to obtain working model and making the bite block. The third visit is bite block try-in on the patient and placed to working model for fixation on the articulator, followed by tooth color determination and laboratory instructions. The fourth visit is wax obturator try-in and checking occlusion, articulation, aesthetics and phonetics. The fifth visit is definitive obturator insertion and follow up. Conclusion: Definitive obturator can rehabilitate defects post maxillary tumor surgery.Keywords: Maxillary defect, definitive obturator, Hollow bulb technique
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Mishra, Ananya, Kasim Mohamed, Prasanna Kumar, and Sathish Kumar Jayagandhi. "Prosthetic Rehabilitation of Maxillectomy Defects, with Single-Piece Open-Hollow Bulb Definitive Obturator." Journal of Evolution of Medical and Dental Sciences 10, no. 16 (2021): 1169–73. http://dx.doi.org/10.14260/jemds/2021/248.
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Patients who undergo surgical resection of the maxillo-mandibular structures as a result of trauma, infection or malignancy, suffer from psycho-social setbacks which has a profound impact on their over-all quality of life. 1,2 These defects, especially those following maxillectomy, result in oroantral communication, facial deformation, impaired speech and difficulty in deglutition. For the rehabilitation of patients with such defects, surgical and prosthetic treatment options are available. As, not all patients can be successfully rehabilitated with reconstructive surgeries due to postoperative complications like graft rejection, the extent of the surgical defect and high psychological impact factor associated with repeated surgeries, prosthetic rehabilitation proves to be an alternative treatment option. The prosthetic rehabilitation of such patients is challenging as it requires restoration of the lost form, function and aesthetics, under constantly changing state of post-surgical intraoral tissues, with limited mouth opening. The maxillofacial prosthesis designed to close congenital or an acquired tissue opening, primarily of the hard palate, is known as an obturator. 3 The obturator has two functional components, one seals the surgical defect and the other replaces the lost dentoalveolarstructures.4-7 The design of an obturator may vary depending on the extent of the defect, remnant dentoalveolar complex, soft tissue undercuts and existent muscle physiology.8,9 Among the two designs, solid and hollow, hollow obturators are widely used. The bulb portion of the hollow obturator, which accommodates the surgical defect, can be open or closed9,10and its selection depends on the prosthodontist’s clinical decision-making skills and the ease of fabrication. In this article we have discussed the rehabilitated patients with single-piece, openhollow bulb definitive obturator. Patients undergo extensive maxillary surgical resections due to aggressive lesions like malignancies and deep fungal infections. Prosthetic rehabilitation of such patients with an obturator becomes of paramount importance as it separates the oropharynx from the nasopharynx, reduces the risk of recurrent infections, replaces lost dentoalveolar structures, permits intelligible speech, reinstates mastication and deglutition, restores facial contour and patient’s self-esteem. The bulb portion of the obturator extends into the defect and accommodates it, forming a hermetic seal. In this clinical report, we highlight the success of prosthetic rehabilitation of maxillectomy patients using single-piece, open-hollow bulb definitive obturator. The meticulous follow-up carried out reveals the success of the prosthesis and adds practice-based evidence to the maxillectomy rehabilitation outcome.
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Hussain, Mehmood, Syed Imran Hassan, Syed Kashif Naqvi, Mohammad Yawar Khan, Moin Khan, and Waqas Tanveer. "RETENTION IN MANDIBULAR OBTURATORS." Professional Medical Journal 21, no. 04 (2018): 755–59. http://dx.doi.org/10.29309/tpmj/2014.21.04.2200.
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Objective: To provide various means of retention in fabrication of mandibularobturators for patients visited Hamdard University Dental Hospital, Karachi. Study Design: It wasa descriptive type of study. Place and Duration of study: The study was carried out at HamdardUniversity Dental Hospital, Karachi. Total duration of this study was two years. Materials andMethods: Nine patients were selected by purposive non-probability sampling technique. Aftertaking consent, self designed Proforma was filled. Age ranged from 13-72 years. Six of them weremales and three females. One of them was already using obturator. With the help of obtainedinformation, various means of retention in maxillary obturator were provided. Results: InterimObturators were fabricated for six patients while definitive obturators were fabricated for threepatients. In eight patients conventional means of retention were employed while implantsupported obturator was provided for one patient. Seven patients were satisfied with theperformance of obturator. In one patient sectional tray was used for impression while in onepatient artificial teeth were arranged by neutral zone technique. Regular follow up was carried outtill one year. Conclusions: Utilization of various means of retention brings better compliance inmandibular defect patients provided with obturators.
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Singh, M., I. K. Limbu, P. K. Parajuli, and R. K. Singh. "Definitive Obturator Fabrication for Partial Maxillectomy Patient." Case Reports in Dentistry 2020 (March 21, 2020): 1–4. http://dx.doi.org/10.1155/2020/6513210.
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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.
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Tenripada, Novi, M. Th Esti Tjahjanti, and Erwan Sugiatno. "Rehabilitasi Prostetik Paska Hemimaksilektomi pada Pasien Edentulos." Majalah Kedokteran Gigi Indonesia 19, no. 2 (2012): 150. http://dx.doi.org/10.22146/majkedgiind.15539.
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Latar belakang. Hemimaksilektomi adalah reseksi sebagian maksila pada satu sisi. Defek yang dihasilkan setelah hemimaksilektomi akan menyebabkan kecacatan pada wajah serta akan menimbulkan gangguan stomatognatik. Rehabilitasi prostetik merupakan suatu bagian yang penting dalam rekonstruksi rongga mulut pasien pasca pembedahan kanker rongga mulut. Upaya rehabilitasi ini mencakup bentuk perawatan yang melibatkan kerjasama multidisipliner dengan bagian ilmu penyakit mulut, bedah onkologi dan prostodonsi. Tujuan. Penulisan laporan kasus ini bertujuan untuk menginformasikan rehabilitasi prostetik pasca hemimaksilektomi untuk pasien edentulous. Kasus dan penanganan. Pasien laki-laki berumur 65 tahun datang ke RSGM Prof Soedomo dengan diagnose kanker di palatum dan akan dilakukan hemimaksilektomi di RSUP Dr Sardjito Yogyakarta. Protesa yang digunakan dalam rehabilitasi prostetik ini adalah obturator imidiat, obturator interim dan obturator definitive. Obturator definitif pada pasien edentulous berupa gigi tiruan lengkap dengan bulb pada sisi defek. Bentuk obturator dibuat dengan mengoptimalisasi retensi dari struktur anatomi yang tersisa. Kesimpulan. Rehabilitasi prostodontik pada pasien edentulous pasca hemimaksilektomi adalah dengan obturator imidiat, obturator interim dan obturator definitive berupa gigi tiruan lengkap dengan bulb. Background. Hemimaxillectomy is resection on unilateral side of maxilla. Maxillary defect that occurred after hemimaxillectomy result in facial deformities and stomatognatic disfunction. Prosthetic rehabilitation is essential part in oral reconstruction after patient undergone oral cancer surgery. Rehabilitative efforts involve treatment modalities involving multidiscipliner teamwork with oral pathologist, oncologist and prosthodontist. Purpose. Purpose of the report was to inform the prosthetic rehabilitation after hemimaxillectomy in completely edentulous patient. Case and treatment. A 65 years male diagnosed cancer on palatal referred to RSGM Prof Soedomo in order to prepare prosthodontic rehabilitation after hemimaxillectomy in RSUP Dr Sardjito, Yogyakarta. Prosthesis used in this rehabilitation were immediate obturator, interim obturator and definitive obturator. Obturator for completely edentulous patients is complete denture with the bulb on defect side. The shape of obturator was designed to optimalize retention from the remaining anatomical structure. Conclusion. Prosthetic rehabilitation for hemimaxillectomy edentulous patient were immediate obturator, interim obturator and definitive obturator.
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Sugiyo, Paul, and Heriyanti Amalia Kusuma. "Obturator Definitive Mandibula Post Hemimandibulectomy Sinistra." Majalah Kedokteran Gigi Indonesia 19, no. 2 (2012): 158. http://dx.doi.org/10.22146/majkedgiind.15541.
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Latar Belakang. Operasi bedah pemotongan mandibula pada kasus tumor jinak maupun tumor ganas dapat menyebabkan deviasi mandibula. Tindakan perawatan bedah tergantung pada lokasi dan perluasan tumor mandibula, tindakan perawatan bedah tersebut meliputi bedah marginal, segmental, hemimandibulectomy, dan total mandibulectomy. Tujuan. Makalah ini menjelaskan tentang perawatan rehabilitasi dengan obturator definitive mandibula. Para klinisi harus menunggu masa penyembuhan yang sempurna sebelum disarankan untuk dibuatkan onturator definitive mandibula. Sejak awal penyembuhan diperlukan intervensi prostodontis untuk mencegah deviasi mandibula. Protesa ini membantu pergerakan mandibula secara normal tanpa terjadi penyimpangan pada fungsi bicara dan pengunyahan. Laporan Kasus. Pada bulan Maret 2012, pasien laki-laki, berumur 46 tahun datang ke RSGM Bagian Prostodonsia atas rujukan dari RS. Dr. Sardjito Bagian Bedah Mulut setelah dilakukan operasi tumor ameloblastoma mandibula sinistra (post hemimandibulectomy mandibula sinistra) dengan pemasangan plat rekonstruksi tiga bulan sebelumnya untuk dibuatkan obturator definitive mandibula. Pasien mengeluh bibir bawah sebelah kiri sering tergigit, fungsi bicara, fungsi pengunyahan, dan penampilannya terganggu. Hasil. Setelah dilakukan perawatan dengan memakai obturator definitive mandibula dalam kurun waktu 8 bulan, hingga saat ini hasil perawatan ini dapat mengembalikan fungsi bicara, fungsi pengunyahan, dan fungsi estetik sehingga pasien merasa lebih nyaman dan percaya diri. Kesimpulan. Deviasi mandibula setelah operasi hemimandibulectomy diatasi dengan bedah rekonstruksi menggunakan plat rekonstruksi, kemudian segera setelah penyembuhan perlu melibatkan prostodontis untuk pemasangan obturator definitive mandibula. Background. Surgical restion of the mandible due to presence of benign or malignant tumor is the common cause of the mandibular deviation. Depending upon the location and extent of the tumor in the mandible, various surgical treatment modalities like marginal, segmental, hemimandibulectomy, or total mandibulectomy. Purpose. This study was to deteminated of rehabilitation treatment by mandible definitive obturator. The clinicians must wait for extensive period of the time for completion of healing before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes management of a patient who has undergone a reconstructed hemimandibulectomy with mandible definitive obturator. The prosthesis help patient moving the mandible normally without deviation during functions like speech, mastication, and aesthetic. Case Report. On March 2012, a 46 years old man was referred from Dr. Sardjito Hospital Oral Surgery Department to Department of Prosthodontics RSGM Faculty of Dentistry Gadjah Mada University Yogyakarta, for prosthetic rehabilitation following a hemimandibulectomy sinintra reconstructed with plate reconstruction three months ago. Patient felt speech function, masticatory function, and impaired performance, lower lip frequently bitten. Results. After treated while 8 months till now by mandible definitive obturator, patient felt more comfortable and confident with recovery function of speech, mastication, and aesthetic. Conclusion. The deviation of mandible after hemimandibulectomy was reconstructed by reconstruction plate surgery. During this initial healing period early prosthodontic intervention by mandible definitive obturator.
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Subhajit, Sen, Mukhopaadhyay Sruti, and Das Samiran. "Recreating lost smile - A definitive obturator." Journal of Orofacial Rehabilitation 2, no. 3 (2022): 35–41. https://doi.org/10.5281/zenodo.7491129.
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<strong>Abstract</strong> Acquired or congenital maxillectomy defects may cause oroantral communication that leads to nasal regurgitation, difficulty in chewing and swallowing, speech problem, and facial deformities. Obturator prosthesis act as an important mode of rehabilitation for these defects. In this paper, an obturator prosthesis fabrication with a metal framework design, for maxillary defect is discussed. A linear design was formulated as given by Mohamed A. Aramany. Occlusal rests were prepared on the maxillary left premolars and molars. Complete palatal major connector was planned so that maximum amount of the masticatory load would be distributed to the underlying tissues. Direct retention was provided by the embrasure clasps. Thus, this definitive prosthesis helped to restore back the lost structures and function by closing the communication between different cavities.
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Natung, Joram, Anjana S. Raj, and Indu Raj. "REHABILITATION OF MAXILLARY DEFECTS IN PARTIAL AND COMPLETE EDENTULOUS ARCHES WITH DEFINITIVE OBTURATORS-A CASE SERIES." International Journal of Advanced Research 11, no. 07 (2023): 1119–28. http://dx.doi.org/10.21474/ijar01/17324.
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Rehabilitation of hemimaxillectomy patients can be challenging. The most common problem with prosthetic treatment in such patients is in getting adequate retention, stability, and support. The size and location of the defect usually influences the amount of impairment and difficulty in prosthetic rehabilitation. The obturator prosthesis is commonly used as an effective means for rehabilitating hemimaxillectomy cases. In this case series prosthetic rehabilitation of a completely edentulous and partially edentulous patients with definitive obturators have been discussed.
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Vedant Dhananjay, Kulkarni, Arjita Dutta, Nitin Kaushik, and Akriti Kaul. "HOLLOW DEFINITE OBTURATOR FOR UNILATERAL SUBTOTAL MAXILLECTOMY REHABILITATION - A CLINICAL REPORT." International Journal of Advanced Research 12, no. 10 (2024): 958–63. http://dx.doi.org/10.21474/ijar01/19716.
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Palatal defects, resulting from congenital malformations, trauma, diseases, radiation therapy, or surgical interventions like maxillectomy, pose significant functional and aesthetic challenges. These defects often lead to speech impediments, difficulties in mastication and swallowing and compromised oral hygiene. An obturator prosthesis plays a crucial role in rehabilitating these patients by restoring oronasal separation, improving speech, mastication and overall quality of life. This case report details the prosthetic rehabilitation of a 45-year-old female patient with a subtotal maxillectomy defect using a definitive hollow obturator. The transition from an interim to a definitive obturator significantly enhanced the prosthesiss retention, stability and patient comfort. The fabrication process for the hollow obturator, along with the clinical challenges and solutions, is discussed in detail. The successful outcome highlights the importance of sound prosthodontic principles and the strategic design of obturator prostheses to optimize both function and aesthetics. Future directions may include advancements in 3D printing technologies to further improve obturator fabrication and patient outcomes.
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kalaignan, Parithimar, and Jaya Shree Mohan. "Impact of Maxillofacial Prostheses on Oral Health Related Quality Of Life (OHRQoL)." Biomedical and Pharmacology Journal 11, no. 2 (2018): 743–49. http://dx.doi.org/10.13005/bpj/1428.
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Maxillofacial defects cause impact on oral health related quality of life (OHRQol) including limitations in functional activities, communication, social interaction, and intimacy. The obturator prosthesis is commonly used as an effective means for rehabilitating maxillectomy patients. The purpose of this study was to investigate impact of definitive obturator prosthesis on oral health related quality of life. In the period between 2015 -2017, a total of twenty five (25) patients with acquired maxillary defects based on Okay classification have been selected and rehabilitated with definitive obturator prostheses .The OHRQol was measured using the Oral Health Impact Profile (OHIP-Edent-19) and Obturator functioning scale (OFS) with standardized questionnaire after 2 weeks & 3months of prosthesis function.To find the significant difference between the bivariate samples in Paired groups the Wilcoxon signed rank test was used. With respect to oral health impact profile –Edent 19 scale, the mean functional limitation score were 6.72 and 5.20 indicates that there is significant improvement in chewing performance after 2 weeks and 3 months of prosthesis function. Significant improvement in oral health impact profile was noticed in physical (M = 5.84, 4.88), Psychological (M=4.84, 3.96) and social disabilities (M=5.28, 4.16). Similarly, when observed with Obturator functioning scale, significant improvement were noted in chewing performance phonetics, appearance and miscellaneous aspects. Analysing the OHIP –Edent-19 scale and obturator functioning scale (OFS-15), statistically significant differences (Wilcoxon rank test p value = 0.0005) were observed. Within the limits of this study, it can be concluded that highly positive correlation exists between definitive obturator prostheses and oral health related quality of life (OHRQol).
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Amuthan. S, Shakila. R, and Ranukumari. A. "Fabrication of a definitive obturator for a patient with partial maxillectomy defect following post-covid mucormycosis: A case report." International Journal of Science and Research Archive 12, no. 2 (2024): 1185–90. http://dx.doi.org/10.30574/ijsra.2024.12.2.1352.
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Mucormycosis was a rapidly progressing and life-threatening fungal infection. After surgery, we should anticipate seeing more individuals with orofacial abnormalities given the total number of cases and the orofacial region's primary involvement in the previous COVID-19 pandemic. Thus, in order to improve the quality of life for individuals suffering from mucormycosis, maxillofacial prosthetic rehabilitation is of paramount importance. Postoperative maxillary defects can be rehabilitated through surgical and prosthetic procedures. An obturator was utilized as a part of prosthetic management to facilitate efficient deglutition and articulation. It also provides support for the facial soft tissue to restore the midfacial contour in cases of palatal defects. This case report describes about the fabrication of a definitive palatal obturator for a patient with postsurgical maxillary defect wearing interim obturator made of polymethyl methacrylate (PMMA). Food impaction and irritation of the fitting surface over the tissue defect, resulting in erythema to the tissue surface and discomfort of using interim obturator. With the remaining teeth and tissues serving as support, the definitive obturator made of cobalt and chromium was made. With no degradation in the prosthesis, the follow-up showed satisfactory outcomes.
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Vijayabharathi, P., Surabhi Rambhau Somkuwar, Santhosh Rao, Virat Galhotra, and Uvashri Selvaraj. "Impact of prosthodontic rehabilitation on psychological status and quality of life in maxillectomy patients of coronavirus disease 2019-associated mucormycosis at a tertiary care center: A prospective clinical study." Journal of Indian Prosthodontic Society 24, no. 4 (2024): 351–58. http://dx.doi.org/10.4103/jips.jips_156_24.
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Aims: The study was aimed to evaluate the effect of prosthodontic rehabilitation on psychological status (PS) and quality of life (QoL) in maxillectomy patients of coronavirus disease 2019-associated mucormycosis (CAM). Settings and Design: The study was designed as a prospective and clinical study. Materials and Methods: Twenty-four CAM patients undergoing maxillectomy and subsequent prosthetic rehabilitation were included. The treatment involved surgical, intermediate, and definitive obturator delivery at various phases of healing. PS was assessed using the Hospital Anxiety and Depression Scale (HADS), QOL using the European Organization for Research and Treatment of Cancer QoL Questionnaire-Head and Neck Module (EORTC QLQ-HandN35), and the functioning of obturator was assessed utilising the Obturator Functioning Scale (OFS) at various time points: before maxillectomy (T1), 2 weeks after maxillectomy (T2), 2 weeks upon usage of intermediate obturator (T3), just before delivery of definitive obturator (T4), and 12 weeks after the usage of definitive obturator (T5). Statistical Analysis Used: Data were analyzed using a social science statistical analysis program (Stata 14.0; StataCorp LLC, Texas, USA). The significance level was chosen <0.05. Shapiro–Wilk test was used to assess the normality of quantitative data. Student’s t-test was employed (α =0.05) to evaluate if the patient’s PS, QOL, and obturator function had changed over time. The Spearman correlation coefficient (α =0.05) was utilized to evaluate the correlation coefficient between PS, QOL, and obturator function seen at T3 and T5. Results: Out of 24 enrolled patients, nine were dropped out. HADS-anxiety score was the highest at T1 (18.6 ± 1.2) and HADS-depression score was the highest at T2 (18.8 ± 1.6). HADS scores decreased significantly (P = 0.001) after prosthetic rehabilitation. EORTC QLQ-HandN35 score was the highest at T2 (105.8 ± 29.5), with statistical significance (P = 0.001) after rehabilitation. OFS was the highest at T3 (51.9 ± 3.9) and lowest at T5 (25.4 ± 2.8). Conclusion: CAM and maxillectomy deliberately affects the PS and QOL. Prosthetic rehabilitation, psychological motivation, and education create greater improvement in PS and QOL. The progress in parameters showed an upward trend with good obturator quality over a period of time.
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Akshita, Arora, and Dutta Senjuti. "Immediate and definitive hollow bulb obturator for partial maxillectomy – A case report." Journal of Orofacial Rehabilitation 4, no. 3 (2024): 44–48. https://doi.org/10.5281/zenodo.14546694.
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<strong>Abstract</strong> <strong>Abstract</strong>: For patients with partial or total maxillectomy defects, prosthetic rehabilitation with an obturator prosthesis is the gold standard treatment, offering optimal functional and cosmetic outcomes. The hollow obturator prosthesis reduces the load on the underlying and surrounding tissues. It is fabricated using a simple, cost-effective technique. A wax pattern is generated to replicate the defect area, which is then filled with water, frozen and used as a template. The resulting ice block is sandwiched between two layers of heat-cured acrylic resin, ultimately forming the prosthetic device. After curing, a hole is made to remove the ice block, leaving a hollow space, which is then filled with cold-cure acrylic resin, and a lightweight, uniformly thick prosthesis is created. <strong>Keywords</strong>: Hollow bulb obturator, partial maxillectomy, prosthetic rehabilitation.
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Arifialda, Alda, Lisda Damayanti, and Helmi Siti Aminah. "Rehabilitasi fungsi dan estetika pada pasien pasca hemimandibulektomi dengan obturator definitif: laporan kasus." Jurnal Kedokteran Gigi Universitas Padjadjaran 36, no. 1 (2024): 106–16. http://dx.doi.org/10.24198/jkg.v36i1.49681.
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ABSTRAKPendahuluan: Hilangnya struktur anatomi mandibula dapat disebabkan oleh karena malformasi kongenital, trauma, serta reseksi dengan menghilangkan jaringan tumor. Tumor ameloblastoma seringkali melibatkan sejumlah tulang pada mandibula dan metastasis dapat terjadi sehingga harus dilakukan reseksi. Defek yang mempengaruhi fungsi bicara, pengunyahan serta penelanan merupakan konsekuensi dari dilakukannya reseksi, sehingga pembuatan obturator menjadi penting untuk dilaksanakan. Laporan kasus ini bertujuan untuk memaparkan tatalaksana rehabilitasi fungsi dan estetika pada pasien post hemimandibulektomi dengan obturator definitif. Laporan kasus: Seorang laki-laki berusia 19 tahun datang ke Departemen Prostodonsia Rumah Sakit Hasan Sadikin Bandung untuk dibuatkan protesa pasca reseksi. Pasien telah menjalani operasi hemimandibulektomi disertai rekonstruksi plat dengan riwayat medis terdiagnosa ameloblastoma tipe plexiform ar. mandibula sinistra. Pasien merasa fungsi bicara, penelanan serta penampilannya terganggu karena setiap pergerakan membuka mulut, rahang mengalami deviasi dan kesulitan untuk mengunyah makanan yang halus sekalipun. Secara klinis pada bagian defek yang dipasang plat tidak ada rasa sakit, inflamasi serta infeksi sehingga dilakukan penatalaksanaan obturator definitif dengan pertimbangan agar dapat memulihkan fungsi pengunyahan dengan segera dan untuk memperoleh stabilitas oklusi. Pasien dibuatkan obturator definitif mandibula kerangka logam dengan metode pencetakan alter cast. Simpulan: Penatalaksanaan rehabilitasi dengan obturator definitif mandibula dapat memulihkan fungsi bicara, pengunyahan dan penelanan serta meningkatkan kepercayaan diri pasien.Kata kunciobturator definitif mandibula, pencetakan alter cast, hemimandibulektomi, ameloblastoma Aesthetic and functional rehabilitation on post hemimandi-bulectomy patient with obturator definitiveABSTRACTIntroduction: Losing part of the mandible structure might be caused by congenital malformations, trauma, and surgical resection by removing a tumor. It is frequently found that ameloblastoma involves several bones of the mandible and metastasis might occur resulting in mandible resection. As a consequence, the defects would occur and influence some functions including speech and swallowing so the fabrication of an obturator was necessarily needed. Case report: A 19 years old male came to the Department of Prosthodontics Rumah Sakit Hasan Sadikin Bandung required a prosthesis after surgical resection. The patient has been diagnosed with ameloblastoma plexiform type ar. mandibula sinistra and underwent hemimandibulectomy including plate reconstruction inserted. There are some impairments in speaking, swallowing also reduced visual performance because of mandibular deviation and chewing difficulty, even soft food most of the time. Mandibula definitive frame obturator was then delivered to the patient with the alter cast impression method. Conclusion: The rehabilitation with the mandible definitive obturator gained some function including speech, chewing, and swallowing and there’s an improvement in the patient’s self-esteem.Keywordsmandible definitive obturator, alter cast impression, hemimandibulectomy, ameloblastoma
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Singh, Saumyendra V., Anshu Baid, and Deeksha Arya. "CAD-CAM approach to optimize management of post-COVID-19 mucormycosis maxillectomy patients: A case report." IP Annals of Prosthodontics and Restorative Dentistry 10, no. 4 (2024): 350–54. https://doi.org/10.18231/j.aprd.2024.068.
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A 34-year-old male patient was referred to the department after treatment of his right premaxilla and nasal cavity post-COVID-19 mucormycosis for prosthodontic management. Treatment planning included the fabrication of an interim obturator prosthesis followed by a definitive prosthesis at a later stage.The interim obturator was fabricated using conventional techniques, but digital technology was used to fabricate the definitive prosthesis. Impressions were made using an intraoral scanner, and virtual designing and 3D printing of the framework was done using CAD/CAM (Computer Aided Designing/ Computer Aided Manufacturing)
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Singh, Saumyendra V., Anshu Baid, and Deeksha Arya. "CAD-CAM approach to optimize management of post-COVID-19 mucormycosis maxillectomy patients: A case report." IP Annals of Prosthodontics and Restorative Dentistry 10, no. 4 (2024): 350–54. https://doi.org/10.18231/j.aprd.2024.067.
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A 34-year-old male patient was referred to the department after treatment of his right premaxilla and nasal cavity post-COVID-19 mucormycosis for prosthodontic management. Treatment planning included the fabrication of an interim obturator prosthesis followed by a definitive prosthesis at a later stage.The interim obturator was fabricated using conventional techniques, but digital technology was used to fabricate the definitive prosthesis. Impressions were made using an intraoral scanner, and virtual designing and 3D printing of the framework was done using CAD/CAM (Computer Aided Designing/ Computer Aided Manufacturing)
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Mohamed Usman, Jafar Abdulla, Anuroopa Ayappan, Dhanraj Ganapathy, and Nilofer Nisha Nasir. "Oromaxillary Prosthetic Rehabilitation of a Maxillectomy Patient Using a Magnet Retained Two-Piece Hollow Bulb Definitive Obturator; A Clinical Report." Case Reports in Dentistry 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/190180.
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Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator.
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Pawar, Priyanka R., Smita A. Khalikar, Shankar P. Dange, and Kishor Mahale. "Modified Two Unit Oral Characterizedand Hollow Detachable Definitive Obturator Fabrication Technique for Rehabilitation of Post Mucormycosis Bilateral Maxillectomy Patient-A Clinical Case Report." International Journal of Advance Research and Innovation 10, no. 4 (2022): 14–21. http://dx.doi.org/10.51976/ijari.1042203.
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Maxillary defects are created by surgical treatment of benign or malignant neoplasms, congenital malformation, trauma and recently because of post covid mucormycosis. The size and location of the defects influence the degree of impairment and difficulty in prosthetic rehabilitation. Lack of support, retention, and stability are common prosthodontic treatment problems for patients who have had a maxillectomy. A prosthesis used to close a palatal defect in a dentate or edentulous mouth is referred to as an obturator. The obturator prosthesis is used to restore masticatory function and improve speech, deglutition and cosmetics for maxillary defect patients. The weight of the maxillary obturator is a dislocating factor because the prosthesis often acts as a cantilever. The laboratory procedure generally used in the construction of a hollow obturator is rather complicated. A more simple and accurate method which facilitates the processing of an obturator will be described. this article discusses about a modified technique to fabricate a two unit oral characterized and hollow detachable definitive obturator for rehabilitation of patient undergone bilateral maxillectomy after post covid mucormycosis.
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Rajat, Chaudhari, Mahale Kishor, Khalikar Smita, and Rajguru Vilas. "Maxillary hollow definitive obturator for hemi maxillectomy using biodentplast framework: A case report." Journal of Orofacial Rehabilitation 4, no. 2 (2024): 58–63. https://doi.org/10.5281/zenodo.13369184.
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<strong>Abstract</strong> Defects inside the mouth can be present from birth or develop later and are most often found in the upper jaw. Typically, these are large gaps found in the roof of the mouth or the surrounding structures near the roof of the mouth. Many patients who have undergone maxillary surgery often experience persistent functional impairments and physical disfigurement. One of the most common jaw abnormalities is a patient with oral cancer. The goal in treating this condition is to provide a prosthesis that is comfortable and aesthetically pleasing, and can help restore normal functions such as swallowing, talking, and chewing. An obturator shows great potential for addressing this particular issue. It mainly functions to close the gaps and meet the essential needs and appearance of the patients in question. This article describes a case report of a hollow bulb obturator for a hemimaxillectomy patient <strong>Keywords: </strong>Biodentaplast, hollow obturator, maxillary defect, rehabilitation.
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Mishra, SunilKumar, Puja Hazari, and Amit Khare. "Prosthodontic rehabilitation of velopharyngeal insufficiency with definitive obturator." Journal of Cleft Lip Palate and Craniofacial Anomalies 4, no. 2 (2017): 164. http://dx.doi.org/10.4103/jclpca.jclpca_17_17.
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Singh, Kirandeep, Parag Dua, NSC Charles, and Sangeeta Sehrawat. "A simplified technique for fabrication of obturator using light curing wax pattern: A case report." IP Annals of Prosthodontics and Restorative Dentistry 8, no. 2 (2022): 116–20. http://dx.doi.org/10.18231/j.aprd.2022.023.
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Surgical excision of the maxilla results in communication between the oral cavity, nasal cavity and maxillary sinus. Rehabilitation of such defects involves fabrication of obturator prosthesis by the maxillofacial prosthodontist. Various techniques and materials have been used in the past for rehabilitation of such defects.To Fabricate a Obturator Prosthesis using Light Cure Wax Pattern.A 65-year-old man reported with the chief complaint of inability to chew food due to an ill-fitting prosthesis. His history revealed that patient had undergone maxillectomy of left side due to Carcinoma maxilla 03 years back, followed by the fabrication of a definitive obturator prosthesis. Intraoral examination revealed a well healed Aramany’s Class II post maxillectomy defect on the left side measuring 5 cm X 3.5 cm anteroposteriorly and mediolaterally, with everted margins and irregular borders. This clinical report describes rehabilitation of maxillectomy defect with definitive obturator prosthesis. A light cure wax pattern was used (LiWa®; Willmann & Pein Gmbh) for the fabrication of metal framework. Fabrication of a cast metal framework involves a complex laboratory procedure to achieve the clinical success of the prosthesis. LiWa light curing waxes can be successfully used as an alternative to the conventional wax pattern for the fabrication of cast partial dentures framework for definitive obturators.The light cure wax pattern helped in reducing the number of laboratory steps and allowed wax pattern trial in the patient's mouth, saving precious time and ensuring a precise fit of the prosthesis.
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Sapat, Makrand, Chandan Rathod, Fatema Sodawala, and Javed Sodawala. "Tooth Implant-supported Obturator for a Hemimaxillectomy Patient." International Journal of Prosthodontics and Restorative Dentistry 7, no. 4 (2017): 129–32. http://dx.doi.org/10.5005/jp-journals-10019-1191.
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ABSTRACT The esthetic and functional rehabilitation of the patients with palatal defects using obturator poses challenge to the clinician. The use of existing teeth along with implants helps in providing good retention, support, and stability to the prosthesis. Ball-socket type of attachments offer efficient, yet economical alternative to these patients. This case report describes management of a hemimaxillectomy adult patient with a class II palatal defect using tooth implant-supported obturator. Osseointegrated implants and direct overdenture post with ball-socket type of attachments were used to construct a definitive obturator for prosthetic rehabilitation of this patient. How to cite this article Rathod C, Sapat M, Sodawala F, Sodawala J. Tooth Implant-supported Obturator for a Hemimaxillectomy Patient. Int J Prosthodont Restor Dent 2017;7(4):129-132.
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Sharaf, Mohamed Yahia, and Asharaf Email Eskander. "PEEK versus Metallic Attachment-Retained Obturators for Patient Satisfaction: A Randomized Controlled Trial." European Journal of Dentistry 16, no. 01 (2021): 80–95. http://dx.doi.org/10.1055/s-0041-1731839.
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Abstract Objective The aim of the study was patients’ satisfaction evaluation and radiographic evaluation of the terminal abutments of attachment-retained maxillary obturators with metal framework versus milled polyetheretherketone (PEEK) framework in the management of maxillectomy cases. Materials and Methods Eighteen participants were randomly divided into three parallel groups (n = 6). Participants of the PEEK group received attachment-retained obturators with milled PEEK framework, the metal group received an attachment-retained obturator with a metallic framework, and the conventional group received conventional clasp-retained obturators with a metallic framework (Control group). The evaluation included was radiographic evaluation and patients’ satisfaction in this study included two scales—”The Obturator Functioning Scale” and “The European Organization for Research and Treatment of Cancer Head and Neck 35” using one-way ANOVA test. Results Both PEEK and metal groups showed a statistically significant lower mean bone loss (p <0.050) compared with the conventional group during all follow-up periods. There is no statistically significant difference between the PEEK and metal groups during all follow-up periods. Regarding patient satisfaction, both the PEEK and metal groups showed a statistically significant decrease score (p <0.050) compared with the conventional group in various aspects of patients’ satisfaction scales as satisfaction with the look and difficulty of talking to the public, and noticeable clasps. In comparison, the PEEK group showed a statistically significant decrease score (p <0.050) than the metal group with respect to satisfaction with the look along all follow-up periods. Conclusions PEEK attachment-retained maxillary definitive obturators could be considered a promising treatment modality for patients with acquired maxillary defects with regard to esthetics and satisfaction.
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Chaithanya, Reddy, P. Sesha Reddy, Sravani Pampana, and Vineeth Guduri. "A Case report on remarkable healing by secondary intention in a hemi-maxillectomy patient rehabilitated with obturator prosthesis." International Journal of Dental Materials 06, no. 03 (2024): 77–80. http://dx.doi.org/10.37983/ijdm.2024.6305.
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This case reportdescribes a situation in which an impressive recovery through secondary intention occurred in a patient who had a hemi-maxillectomy, and this was followed by comprehensive rehabilitation involving multiple disciplines. The pre-surgical prosthetic planning was done before the surgical excision of the tumour. Phased treatment was executed with a surgical obturator immediately post resection, hollow-bulb interim obturator during the healing phase and cast partial denture definitive obturator after recovery. Rapid healing was achieved by secondary intention, and a drastic reduction in the volume of defects was observed. Follow-up revealed successful patient rehabilitation to lead a good quality of life.
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Salvi, Raj Chandrakant, Manish Chauhan, Jyoti Tembhurne, Arti Gangurde, Niraja Jaiswal, and Madhura Jadhav. "Rehabilitation of post mucormycosis surgical defect using definitive obturator with cast metal framework- A case report." International Journal of Oral Health Dentistry 9, no. 2 (2023): 151–55. http://dx.doi.org/10.18231/j.ijohd.2023.029.
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The recent outbreak of covid-19 disease has led to development of mucormycosis in immunocompromised individuals. Treatment options include antifungal drugs, surgical removal of infected tissues, and management of underlying metabolic disorders. Surgery typically includes the complete excision of the diseased region. These defects put the patient at risk for nasal twang, fluid leaks into the nasal cavity, and poor masticatory function. In such defects, the obturator prosthesis can create an oro-nasal seal. This case report describes the rehabilitation of post mucormycosis surgical defect using definitive obturator using cast metal framework.
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Dr., Shrishti Bhardwaj, Lalit Kumar Dr., and Komal Sehgal Dr. "Rehabilitation of Post Covid Mucormycosis Maxillectomy Defect With Hollow Obturator." Heal Talk - A Journal of Clinical Dentitsry 16, no. 1 (2023): 49–51. https://doi.org/10.5281/zenodo.10071096.
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A 40-year old male patient reported to the OPD with a chief complaint of difficulty in eating, drinking and speaking. He had undergone maxillectomy due to post covid mucormycosis 1 year back. Treatment plan: Definitive hollow bulb obturator. It was made hollow to reduce the weight of the obturator. Primary and final impressions were taken and cast was formed. The hollow bulb was made with lost salt technique to reduce the weight.
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Belal, Ammar, and Abdul Mouin Aljammal. "Fabrication of a Custum ocular and definitive palatal obturator." International Journal of Research in Medical Science 2, no. 1 (2020): 09–12. http://dx.doi.org/10.33545/26648733.2020.v2.i1a.17.
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Fernandez, Teny, Sheela V. Rodrigues, and KR Vijayanand. "A Titanium Cast Hollow Definitive Obturator Prosthesis for a Maxillectomy Patient." International Journal of Prosthodontics and Restorative Dentistry 6, no. 3 (2016): 69–72. http://dx.doi.org/10.5005/jp-journals-10019-1159.
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ABSTRACT Oral cancer necessitates the surgical removal of all or part of the maxilla. The extent of surgical resection is dependent on the size, location, and potential behavior of the tumor. The maxillectomy procedure leaves the patient with a defect that compromises of the integrity and function of the oral cavity, leading to hypernasal speech, fluid regurgitation into the nasal cavity, and impaired masticatory function. Rehabilitation of subtotal and total bilateral maxillectomy surgical defects is a complex challenge to the prosthodontist. Prosthetic rehabilitation of the surgical defect with the help of obturator is very important, because the resulting functional deficiencies have a detrimental effect on the quality of life and self-esteem of the patient. How to cite this article Fernandez T, Rodrigues SV, Vijayanand KR. A Titanium Cast Hollow Definitive Obturator Prosthesis for a Maxillectomy Patient. Int J Prosthodont Restor Dent 2016;6(3):69-72.
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Aradya, Anupama, Narahari Ranganatha, Sreeshyla HS, and Giriraj Sandeep. "Fabrication of single piece definitive obturator for post surgical maxillectomy defect during covid-19 pandemic- A Literature review with Clinical case report." Bangladesh Journal of Medical Science 21, no. 4 (2022): 676–84. http://dx.doi.org/10.3329/bjms.v21i4.60272.
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Background: Impacts of primary oncology surgical procedure can impede restoration objectives. Restoring oral function, comfort and aesthetics is a challenge due to limitations in the restorative treatment options. Methodology: Literature review on the responsibilities, role of maxillofacial prosthodontist, materails and retentive aids used for prosthesis, classification of maxillofacial prostheses, recent advancements in MFP and Workflow for the fabrication of obturator prostheses in the COVID-19 pandemic scenario. Case report on the fabrication of Holllow bulb definitive obturator during pandemic crisis. A 47 years old male patient reported for post-surgical evaluation in maxillary posterior region of oral cavity. The patient had partial maxillectomysurgical procedure of squamous cell carcinoma in the palate 5 years back. To replace the gap created, the patient was using interim obturator. He had facial asymmetry and collapse. Prosthodontic rehabilitation with one piece closed hollow bulb obturator was planned & subsequently fabricated for the patient. For our case considering the feasibility & ease of manipulation, heat activated acrylic resin was used for this particular patient for rehabilitation. The method described is easy, simple, time saving & economical. Bulb portion was hollow & made of heat cure resin, so weight was less & less chances of tissue irritation. Results: With the Covid-19 infection protocol measures taken definitive obturator was given to the maxillectomy patient to restore aesthetics, function and comfort as well. After insertion of prostheses mastication, deglutition and phonetics were improved. Breathing problems were resolved and aesthetics was improved. Conclusion: A simplified technical approach for the treatment of a patient with palatal defect of and other supportive structure has been presented in Covid-19 situation following the described infection prevention protocols. The technique presented offers a method of obtaining a detailed impression of the defect and promptly provides the patient with a light weight, easyto- use and flexible tissue- tolerant obturator. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 676-684
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Hakeem, Abrar Ahmad, Shabir Ahmad Shah, and Qazi shazana Nazir. "Rehabilitation of Patient with Acquired Maxillary Defect Using Cast Partial Obturator with Precision Extra Coronal Attachment." International Journal of Science and Healthcare Research 7, no. 2 (2022): 47–52. http://dx.doi.org/10.52403/ijshr.20220408.
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The prosthetic rehabilitation of a patient with maxillary defect is a very challenging task. Obtaining proper retention when almost half the dentition along with the supporting bone is missing is difficult to obtain. Proper knowledge of the anatomy of both the structures lost in resection as well as the remaining portion helps in fabrication of an effective prosthesis. This article describes the management of acquired maxillary defect case with semi precision attachments enhancing the retention of the obturator prosthesis. Keywords: precision attachments, definitive obturator.
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Rathee, Manu, Santhanam Divakar, Prachi Jain, Sandeep Singh, and Sujata Chahal. "Post maxillectomy definitive rehabilitation in post-covid mucormycosis patients using conventional and 3D printed obturator: A twin case report." Acta Marisiensis - Seria Medica 68, no. 4 (2022): 191–96. http://dx.doi.org/10.2478/amma-2022-0032.
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Abstract Maxillectomy is the surgical removal or resection of the maxilla or upper jaw bone. Maxillectomy may be total or partial. It is performed during surgical treatment of cancer and infections (bacterial. fungal) of the oral cavity, nasal cavity and maxillary sinuses. Patient affected from post-Covid mucormycosis require local debridement or surgical resection resulting in maxillectomy. After surgery, patient has difficulty in mastication, speech, and swallowing because of communication between oral and nasal cavity. This may also give rise to psychological challenges and social exclusion. The prosthodontic rehabilitation of such patient using obturator provide a separation between oral and nasal cavity and improve the quality of life of the patient. There are various techniques and materials used for fabrication of definitive obturator. This article discusses the prosthodontic rehabilitation after maxillectomy in post-covid mucormycosis patients using obturator by conventional and 3D printed techniques.
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Ayinala, Mounika, and Gautam Shetty. "Rehabilitation of Maxillary Defect Using Zygomatic Implant Retained Obturator." Case Reports in Dentistry 2021 (October 13, 2021): 1–5. http://dx.doi.org/10.1155/2021/2391331.
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Tumors involving the hard palate, maxillary sinus, or nasal cavity require maxillectomy based on the extent of the lesion. Lack of these boundaries affects the speech, esthetics, and masticatory function. Prosthetic rehabilitation of these defects can be done utilizing zygomatic implants. This present case describes the use of a zygomatic implant to retain a maxillary obturator in a 22-year-old male patient following partial maxillectomy (Brown’s Class 2b) due to odontogenic myxoma. A surgical obturator was secured in position subsequent to the implant placement. Following the healing period, an interim obturator using heat cure acrylic was fabricated. Mechanical retention for the definitive obturator was obtained through the ball attachment suspended from the multiunit abutment of the zygomatic implant. The case was followed up closely for a year to evaluate the function of the prosthesis. The prosthetic rehabilitation not only promoted esthetics and function but also improved the patient’s quality of life.
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Dhaliwal, Harmandeep, Jyoti Tembhurne, Arti Gangurde, Niraja Jaiswal, and Madhura Jadhav. "Prosthetic rehabilitation of hemi-maxillectomy patient with definitive obturator using precision attachment: A case report." International Journal of Oral Health Dentistry 10, no. 3 (2024): 240–45. http://dx.doi.org/10.18231/j.ijohd.2024.042.
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Hemi maxillectomy is often secondary to malignancies and results in significant anatomical and functional deficits that profoundly impact a patient’s quality of life. Prosthetic management, specifically the use of a definitive obturator, plays a crucial role in restoring oral and nasal functionality, speech, mastication, and facial aesthetics in these patients. Patients with Armany Class 1 defects, characterized by unilateral maxillary resection, face unique challenges that necessitate specialized prosthetic intervention. This article describes prosthetic rehabilitation of hemi maxillectomy patient, focusing on the design, fabrication, and fitting of cast partial denture with closed hollow bulb obturator. Precision attachment adds the benefit of improved esthetics and better distribution of stresses to the remaining natural teeth.
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Neupane, G., and B. Sapkota. "Prosthetic Rehabilitation of Patient with Total Maxillectomy with Hollow Bulb Closed Obturator and Cast Partial Denture: A Clinical Report." Journal of Nepalese Prosthodontic Society 4, no. 2 (2021): 103–10. http://dx.doi.org/10.3126/jnprossoc.v4i2.48365.
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Total maxillectomy is the complete resection of one of the two maxillae or resection to the midline. Surgical intervention creates communication between the oral cavity, nasal cavity and maxillary sinus. Postsurgical maxillary defects predispose the patient to hypernasal speech, leakage of food bolus and liquids into the nasal cavity, impaired mastication and various degrees of cosmetic deformities. Prosthodontic rehabilitation with obturator prosthesis restores the missing structures and acts as a barrier between the communications among the various cavities. Hollow bulb obturator with the maximum coverage of the defect aids in retention, stability, support with improved speech resonance and reduced weight on the unsupported side. This clinical report presents the prosthetic management of a patient having total maxillectomy on left side with definitive hollow bulb closed obturator and cast partial denture on the maxilla.
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Dr. Priyanka Tiwari, Dr Priyanka Tiwari. "Rehabilitation of Patient with Maxillectomy using Definitive Hollow Bulb Obturator." International Journal of Dental Research & Development 10, no. 2 (2020): 15–20. http://dx.doi.org/10.24247/ijdrddec20202.
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Rani, Sapna, Sakshi Gupta, and Mahesh Verma. "Hollow bulb one piece maxillary definitive obturator - A simplified approach." Contemporary Clinical Dentistry 8, no. 1 (2017): 167. http://dx.doi.org/10.4103/ccd.ccd_887_16.
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Ahmed, Zain Uddin, Jessica Flynn, Elyn R. Riedel, Joseph M. Huryn, and Evan B. Rosen. "Definitive maxillary obturator prosthesis: Timelines for fabrication and follow‐up." Special Care in Dentistry 40, no. 3 (2020): 315–19. http://dx.doi.org/10.1111/scd.12471.
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Bahrami, Mehran, and Seyed Mehran Falahchai. "Full Mouth Reconstruction of a Skeletal Class II Division 1 Patient with Adenoid Cystic Carcinoma Using an Interim Immediate Obturator and a Definitive Obturator." Case Reports in Dentistry 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/5458617.
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A 61-year-old female patient with adenoid cystic carcinoma (ACC) of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO) and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO) is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD) was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient’s normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.
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Sharma, Vineet, Jyoti Paliwal, Kamal Kumar Meena, and Ramjee Lal Raigar. "Prosthodontic Management of Dentate Maxillectomy Patient: A Clinical Case Report." Acta Marisiensis - Seria Medica 67, no. 4 (2021): 247–50. http://dx.doi.org/10.2478/amma-2021-0038.
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Abstract Patients with minor defects of the alveolar ridge and hard palate can easily be treated by surgical closure, while patients with larger defects are more amenable to prosthetic restoration. The case report describes the rehabilitation of a dentate maxillectomy patient with a definitive closed hollow bulb cast partial obturator. A tripod retainer design was chosen for direct retention in the case. The tripod design consisted of a T-bar clasp placed on the left first central incisor and two embrasure clasps with buccal retention and palatal bracing components between the right first & second premolar and right first & second molar. A complete palate major connector was designed to ensure uniform distribution of functional load across tissues. The remaining teeth, the palate, and the rest provided support for the prosthesis. Prosthetic rehabilitation of the defect with a definitive obturator thus seals tissue openings in the palate, improves deglutition, speech, mastication, aesthetics, and significantly improves quality of life.
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Ullah Khan, Muhammad Waseem, Sabiha Naeem, and Qudsia Iqbal. "Prosthetic Rehabilitation of An Acquired Maxillary Defect with Definitive Obturator Prosthesis- A Clinical Technique." Journal of the Pakistan Dental Association 29, no. 02 (2020): 100–102. http://dx.doi.org/10.25301/jpda.292.100.
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Rimaoui, Sanaa, Khadija El Assraoui, and Samira Bellemkhannate. "Immediate Surgical Obturator Prosthesis: Case Report." European Journal of Dental and Oral Health 4, no. 5 (2023): 17–21. http://dx.doi.org/10.24018/ejdent.2023.4.5.285.
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Resection of the maxilla often results in severe functional, aesthetic, and psychological sequelae. This loss of substance creates breaches that can extend throughout the palatal vault, affecting the maxillary sinus, the nasal cavities, the floor of the orbit, and even the orbital cavities. The prosthetic management of these patients is in fact a complex task involving several immediate, secondary, and definitive stages. The transition from one stage to the next depends on a number of factors, including the post-surgical follow-up and the stage of healing. This article discusses, through a case report, the importance of the immediate obturator in preventing post-operative complications and its role in protecting the surgical site during the initial healing period.
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Bansal, Kriti, Kumari Deepika, Meshi Longdo, and Rekha Gupta. "A DISTINCTIVE APPROACH TO REHABILITATE PATIENT WITH BILATERAL MAXILLECTOMY DEFECT BY TWO-PIECE HOLLOW OBTURATOR- CASE REPORT." International Journal of Advanced Research 12, no. 09 (2024): 1078–83. http://dx.doi.org/10.21474/ijar01/19541.
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An obturator is a common tool for prosthetic rehabilitation following invasive surgery, particularly in a total maxillectomy case. However, loss of teeth, palatal denture-bearing area, and vestibular retentive undercuts leaves an inadequate anatomic base to construct the definitive prosthesis. This results in compromised retention and stability. The retention problem can be resolved by fabricating an obturator that engages remaining undercuts. But in such acquired large defects, if all undercuts are engaged, the prosthesis may become too heavy, non-retentive, and challenging to insert, particularly in patients with very high and large defects. Therefore, in this case fabrication of two-piece magnet retained hollow obturator was described to make a prosthesis light weight with the use of thermoplastic polyvinyl chloride sheet in first part which provides adequate retention by engaging the desirable undercuts. The second part of the obturator was made hollow by the use of urinary catheter that was removed easily after completion of denture processing. After this, both the parts were attached together with the use of magnets. This technique is economical and easy to use to restore both function and esthetics in patients with bilateral maxillectomy defect.
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Tasopoulos, Theodoros, Georgios Kouveliotis, Grigoris Polyzois, and Vasiliki Karathanasi. "Fabrication of a 3D Printing Definitive Obturator Prosthesis: a Clinical Report." Acta Stomatologica Croatica 51, no. 1 (2017): 53–59. http://dx.doi.org/10.15644/asc51/1/7.
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Patil, Pravinkumar Gajanan, and Smita Pravinkumar Patil. "A hollow definitive obturator fabrication technique for management of partial maxillectomy." Journal of Advanced Prosthodontics 4, no. 4 (2012): 248. http://dx.doi.org/10.4047/jap.2012.4.4.248.
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Pathak, Chetan, Achint Khullar, Hitesh Mittal, Salil Pawah, Neha Jain, and Manisha Gulati. "Management of Oromaxillary Defect with a Definitive Obturator using Neutral Zone." International Journal of Oral Care & Research 4, no. 4 (2016): 308–11. http://dx.doi.org/10.5005/jp-journals-10051-0070.
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A, Chibuzo Virginia, Okoronkwo Samuel C, Ngwu Justina N, Unogu Mackson O, Ndubuisi Michael C, and Okoronkwo Esther C. "Cases Requiring Maxillary Obturator Prostheses Rehabilitation among Patient that Attended Maxillofacial Prosthetic Laboratory, Dental Clinic, LUTH from 2013-2023." International Journal of Research and Scientific Innovation XI, no. XII (2024): 55–61. https://doi.org/10.51244/ijrsi.2024.11120006.
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Background: In the course of research work it was observed that after maxillectomy, prosthetic restoration of the resulting defect is the fundamental step because it signals the beginning of patient’s rehabilitation. Aim: The General objectives of this study is to identify the cases requiring maxillary obturator prosthesis, the types of obturator used in the management of the defects and finally to know the causes of maxillary defect among patients that have attended maxillofacial prosthetic Laboratory, Dental Unit at LUTH from 2013-2023. Methods: In this study, a total number of 75 cases of maxillary defects were seen and the patients’ attendance register was accessed with the help of record officers and all data collected were recorded in a datasheet. Results: The analysis of demographic data pertaining to maxillary cases reveals intriguing patterns regarding gender distribution and religious affiliation. In examining, it becomes evident that within the study period (2013-2023), a total number of 75 maxillary cases were recorded, 35 cases in Females, while Males accounted for 40 cases. This indicates a higher prevalence of maxillary defects among males, Moreover, when considering the yearly prevalence of maxillary cases, it is notable that females consistently exhibited a higher number of maxillary cases compared to males in most years, with the exception of 2019 and 2020. This suggests a potential gender-specific susceptibility to maxillary defects, necessitating subsequent examination into underlying physiological and environmental factors contributing to this disparity. Furthermore, an examination of the types of maxillary defects sheds light on the etiology of these conditions. Congenital defects account for the majority of cases. comprising 54.7% of all cases, followed by traumatic defects at 25.3%, and surgical defects at 20%. Interestingly, while the prevalence of congenital and traumatic defects appears relatively balanced between Males and Females, with slight variations in percentages, surgical defects exhibit a notable difference, with males comprising a higher percentage compared to Females (20% vs. 11%). This suggests potential gender-specific differences in the nature of maxillary defects, particularly those arising from surgical interventions. Moreover, religious affiliation appears to influence the distribution of maxillary cases, as evidenced by the breakdown of cases among Christians and Muslims. It is observed that Christians accounted for a higher number of maxillary cases (42) compared to Muslims (33) over the study period while the rationale for this inconsistency are not explicitly stated in the data, it may reflect to Prachy variations in healthcare-seeking behavior, genetic predispositions, or socio-economic factors between the two religious groups. Regarding the types of maxillary obturators, the data reveals variations in treatment modalities utilized for maxillary defects. Feeding plates dental emerged as the predominant type of obturator, representing 56% of cases, followed by definitive obturators at 40%, and immediate surgical obturators at 4%. This distribution underscores the importance of tailored treatment approaches based on the nature and severity of the maxillary defect, with feeding plates likely employed for infants or individuals requiring early intervention for feeding difficulties. The result of test of hypothesis using Chi- Square statistical tool shows that there is a relationship between maxillary defects and the use of obturator. Conclusion: Timely management of these defects with common type of obturator is useful in the practice. It was recommended that dental training and continuous education should be done to practicing dental Technologists.
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Gerdzhikov, Ivan. "OPPORTUNITIES FOR SPEECH RESTORATION IN PATIENTS WITH MAXILLECTOMY. LITERATURE REVIEW." Journal of IMAB - Annual Proceeding (Scientific Papers) 29, no. 2 (2023): 4967–73. http://dx.doi.org/10.5272/jimab.2023292.4967.
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Background: Over the last few years, there has been an increase in oncologic morbidity in the maxillofacial region. A significant increase in cases of cancer of the maxilla has been established. As a result of the surgical treatment of maxillary tumours, the barrier between the oral and nasal cavity is broken, which leads to serious speech disorders. Aim: The purpose of the literature review is to analyse data from different studies on the changes in speech after maxillectomy and the opportunities for its restoration with different types of dentures. Discussion: The opportunities for treatment of patients with maxillary defects include surgical restoration or obturator, as there are contradictory data on what are the optimal means of restoring speech. The predominant opinion is that the choice of treatment method depends on the size and the location of the defects, with most authors considering obturators the optimal means of treatment. Their role in the normalisation of speech function by restoring the barrier between the oral and nasal cavity is indisputably proven. Immediate prosthetics have been found to provide faster and easier recovery of speech. To preserve the achieved results, a three-stage method of treatment with surgical, temporary and definitive obturator is recommended, which restores not only speech but also normal articulation. Conclusion: Surgical treatment of cancer of the upper jaw causes defects differing in size, which seriously disturbs speech function. Depending on the size and location of the defect, specific prosthetic treatment methods are used, with different types of dentures being produced.