J Korean Acad Prosthodont.  2019 Oct;57(4):475-482. 10.4047/jkap.2019.57.4.475.

Prosthetic rehabilitation of soft palate resection edentulous patient with maxillary obturator

• Ryu SB
• Heo SJ
• Koak JY
• Kim SK

• KMID: 2461156
• DOI: http://doi.org/10.4047/jkap.2019.57.4.475

Abstract

This report is a case of 76-year old male patient who had difficulty in swallowing, pronunciation and suffered regurgitation of food. The patient lacks uvula and both tonsils, had short palatoglossal arch and soft palate, as well as defective left palatopharyngeal arch. The height and width of the soft palate defect were measured by reconstructing the Computed Tomography (CT) image in three dimensions. Phonation and soft palate obstructing ability were examined by nasometry and nasal endoscopy. Evaluations on phonetics and swallowing were done and improvements were shown. The patient was satisfied with the results of treatment.

Keyword

Palatopharyngeal insufficiency; Soft palate defect; Obturator; Edentulous jaw

MeSH Terms

Deglutition
Endoscopy
Humans
Jaw, Edentulous
Male
Palate, Soft*
Palatine Tonsil
Phonation
Phonetics
Rehabilitation*
Uvula

Figure

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  Fig. 1 Initial photographs. (A) Maxillary occlusal view, (B) Mandibular occlusal view, (C) Panoramic radiograph, (D) Frontal view on right side, (E) Frontal view, (F) Frontal view on left side, (G, H) There is defect on soft palate and pharyngeal portion.

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  Fig. 2 Preliminary impression. (A) Tray and utility wax, (B) Impression using alginate, (C) Preliminary cast.

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  Fig. 3 (A) Impression for Master cast, (B) Master cast.

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  Fig. 4 Temporary denture. (A) Lateral view, (B) occlusal view, (C) Rear view, (D) Intraoral photo after delivery.

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  Fig. 5 (A) CT sagittal view, (B) CT horizontal view, (C, D) Reconstructing defect area image using Seg 3D.

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  Fig. 6 (A) Functional impression for obturator area, (B) Impression for definitive obturator.

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  Fig. 7 Metal framework. (A) Upper framework including velar and pharyngeal part, (B) Intraoral try-in.

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  Fig. 8 Definitive prosthesis. (A) Lateral view, (B) Rear view, (C) External oral photo, (D) Frontal view on right side, (E) Frontal view, (F) Frontal view on left side, (G) velar and pharyngeal area, (H) Frontal view on velar and pharyngeal area.

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  Fig. 9 T-scan result. (A) Centric occlusal, (B) Right and Left lateral excursion.

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  Fig. 10 Nasometry chart.

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  Fig. 11 Nasal endoscope image. (A) Rest state, (B) Closed state on pharyngeal area.

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