Requirements

Successes of using an obturator in rehabilitation for a maxillectomy patient depend on size and location of defect. Large maxillary defects with a few remaining abutments located in a relatively straight line lead to a decrease in support, stability, and retention of prostheses due to unfavorable leverage. To minimize this leverage, weight reduction of a prosthesis should be considered

By Nam
Write blog

This newsletter describes in general a case of prosthetic rehabilitation using an opened hollow bulb obturator with a precise positioning method of metal framework in a patient who received partial maxillectomy.
This 74 year old man was referred to me from his general dental practitioner. Patient has an existing obturator, which was delivered five years ago. The patient’s chief complaints were difficulty in chewing and watery leakage into the nasal cavity, secondary to loose and unstable denture.

The key to success:
The definitive obturator was packed with heat-polymerizing acrylic resin in a single step for both the denture base and bulb part by modifying the special tray to obtain an accurate functional impression and contouring the master cast prior to fabrication of the meshwork, while precisely maintaining a 2 mm acrylic thickness around the bulb wall. In addition, the final acrylic thickness of the denture base underneath the artificial teeth is reduced at the same time because of the favorable meshwork’s height and contour.
Therefore, the design and fabrication technique demonstrated herein enables us to obtain a lightweight obturator with improved retention and stability, with a reduction of time required for chair-side adjustment such as relining of the bulb

1. Spiro RH, Strong EW, Shah JP. Maxillectomy and its classification. Head Neck 1997;19(4):309-14.
2. Omo J, Sede M, Enabulele J. Prosthetic rehabilitation of patients with maxillary defects in a nigerian tertiary hospital. Ann Med Health Sci Res 2014;4(4):630-3.
3. Murat S, Gurbuz A, Isayev A, Dokmez B, Cetin U. Enhanced retention of a maxillofacial prosthetic obturator using precision attachments: two case reports. Eur J Dent 2012;6:212-17.
4. Patil PG, Patil SP. A hollow definitive obturator fabrication technique for management of partial maxillectomy. J Adv Prosthodont 2012;4(4):248-53.
5. Cardelli P, Bigelli E, Vertucci V, Balestra F, Montani M, Carli SD, et al. Palatal obturators in patients after maxillectomy. Oral Implantol (Rome) 2014;7(3):86-92.
6. Lyons KM, Beumer J 3rd, Caputo AA. Abutment load transfer by removable partial denture obturator frameworks in different acquired maxillary defects. J Prosthet Dent 2005;94(3):281-8.
7. Aramany MA. Basic principles of obturator design for partially edentulous patients. Part II: Design principles. J Prosthet Dent 1978;40:656-62.
8. Wu YL, Schaaf NG. Comparison of weight reduction in different designs of solid and hollow obturator prostheses. J Prosthet Dent 1989;62(2):214-7.
9. Keyf F. Obturator prostheses for hemimaxillectomy patients. J Oral Rehabil 2001;28(9):821-9.
10. Shrestha B, Hughes ER, Singh RK, Suwal P, Parajuli PK, Sherestha P, et al. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material. Case Rep. Dent 2015; 504561
11. MA A. Basic principles of obturator design for partially edentulous patients. Part I: Classification. J Prosthet Dent 1978;40(5):554-7.
12. OhWS,RoumanasE.Alternatetechniqueforfabricationof a custom impression tray for definitive obturator construction. J Prosthet Dent 2006;95(6):473-5.

SOCIAL NETWORK

Fllow us