J Korean Acad Prosthodont.  2019 Oct;57(4):356-363. 10.4047/jkap.2019.57.4.356.

Prosthetic rehabilitation by double-processing technique for edentulous patient with soft palate defect after maxillectomy: A case report

  • 1Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University, Jeonju, Republic of Korea. wjdwls04@gmail.com
  • 2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea.


A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.


Maxillofacial prosthesis; Soft palate abnormalities; Palatal obturator; Double-processing technique

MeSH Terms

Deglutition Disorders
Maxillofacial Prosthesis
Nasal Cavity
Palatal Obturators
Palate, Soft*
Quality of Life
Velopharyngeal Insufficiency


  • Fig. 1 Intraoral photo at first visit. (A) Maxillary occlusal view, (B) Right lateral, (C) Frontal view, (D) Left lateral, (E) Mandibular occlusal view.

  • Fig. 2 Panoramic radiograph at first visit.

  • Fig. 3 (A) Paraffin wax was added on stock tray to adjust to defect, (B) Preliminary impression with irreversible hydrocolloid material, (C) Preliminary stone cast for individual tray.

  • Fig. 4 (A) Border molding of edentulous and velopharyngeal area with modeling compound, (B) Final impression with polyvinyl siloxane, (C) Stone working cast.

  • Fig. 5 (A) Metal framework, (B) 1.0 mm baseplate wax was applied for wall of bulb. Internal space was filled with silicone putty and record base was fabricated, (C) First base of obturator was cured.

  • Fig. 6 (A) Remount index was fabricated with silicone putty, (B) registration of Maxillomandibular relation.

  • Fig. 7 Wax denture try-in. (A) Right, (B) Frontal, (C) Left view.

  • Fig. 8 (A) Maxillary occlusal view, (B) Right, (C) Frontal, (D) Left view, (E) Definitive obturator.

  • Fig. 9 Extraoral photographs. (A) Pre-treatment, (B) Post-treatment frontal view.

  • Fig. 10 Comparison of obturator weight. (A) Old obturator, (B) Definitive obturator.

  • Fig. 11 Extraoral photograph with nasometer.


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