J Dent Rehabil Appl Sci.  2018 Dec;34(4):331-337. 10.14368/jdras.2018.34.4.331.

Prosthetic rehabilitation using an obturator in a fully edentulous patient who had partial maxillectomy

• Chung YJ
• Kim JJ
• Baik J
• Cha HS
• Lee JH

• KMID: 2432370
• DOI: http://doi.org/10.14368/jdras.2018.34.4.331

Abstract

Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.

Keyword

oral cancer; maxillectomy; obturator; complete edentulous

MeSH Terms

Carcinoma, Squamous Cell
Clinical Protocols
Denture Retention
Esthetics
Humans
Maxillary Sinus
Mouth Neoplasms
Prognosis
Rehabilitation*

Figure

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  Fig. 1 Preoperative intraoral photographs. (A) Maxillary occlusal view, (B) Mandibular occlusal view, (C) Frontal view with old prostheses.

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  Fig. 2 Presurgical prosthetic planning. (A) Surgical margin on the study cast, (B) Centric relation record registration.

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  Fig. 3 Surgical obturation phase (A, B) Occlusal rim for surgical obturator, (C) Surgical obturator made of clear acrylic resin, (D) Maxillary occlusal view 2 weeks after maxillectomy, (E) Relined surgical obturator.

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  Fig. 4 Interim obturation phase. (A) Maxillary occlusal view 12 weeks after maxillectomy, (B) Modification of surgical obturator, (C) Intraoral photograph with modified surgical obturator.

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  Fig. 5 Definitive obturation phase. (A) Maxillary occlusal view 16 weeks after maxillectomy, (B, C) Border molding of the definitive obturator, (D) Scar band presented on border molding compound wax, (E) Final impression completed with polyvinyl siloxane.

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  Fig. 6 (A) Mounting of the master cast, (B) Wax obturator, (C) Wash impression completed with light-body polyvinylsiloxane.

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  Fig. 7 (A) Definitive obturator, (B) Extraoral photograph after delivery of definitive obturator.

Reference

References

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2. Beumer J 3rd, Marunick MT, Esposito SJ. Maxillofacial rehabilitation: prosthodontic and surgical management of cancer-related, acquired, and congenital defects of the head and neck. 3rd ed. Chicago: Quintessence Pub;2011. p. 155–212.

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