J Korean Acad Prosthodont.  2020 Jan;58(1):30-34. 10.4047/jkap.2020.58.1.30.

Fabrication of closed hollow obturator for hard palate defect patient undergone maxillectomy

• Jang WH
• Lim HP
• Yun KD
• Park C
• Yang HS

• KMID: 2469918
• DOI: http://doi.org/10.4047/jkap.2020.58.1.30

Abstract

Maxillectomy is performed to remove the tumor in the palate, maxillary sinus, buccal mucosa or nasal cavity. The resection range depends on the size and the extent of the tumor and it affects speech production or cause nasal regurgitation during feeding. Obturator can occlude an opening such as an oro-nasal fistula and protect the defect area. Successful reconstrucion of the patient's oral cavity who have gone over the maxillectomy is a difficult task. The condition and number of teeth, the remaining support area, and the extent of the defect area have a great influence on manufacturing the obturator. If these factors are disadvantageous, the prognosis of the prosthesis is uncertain. The final obturator must have a sufficient retention in the patient's oral cavity and must not irritate the surrounding tissue and support area where the resection was performed.In this case, a 55 year old female went through the maxillectomy and the only 3 teeth remained. And the retention of the maxillary prosthesis seems to be poor. So that, we fabricated the closed hollow obturator which has reduced weight compared to the conventional obturator. Consequently the closed hollow obturator can give better sealing and the adaptation.

Keyword

Closed hollow obturator; Maxillectomy; Obturator

MeSH Terms

Female
Fistula
Humans
Maxillary Sinus
Maxillofacial Prosthesis
Mouth
Mouth Mucosa
Nasal Cavity
Palate
Palate, Hard*
Prognosis
Prostheses and Implants
Tooth

Figure

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  Fig. 1 Initial panoramic radiograph.

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  Fig. 2 Initial intraoral photographs. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

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  Fig. 3 Preliminary impression. (A) Alginate impression, (B) Diagnostic model.

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  Fig. 4 Final impression Analysis of tooth and gingiva. (A) Final impression taking with individual tray, (B) Master cast.

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  Fig. 5 Metal framework design.

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  Fig. 6 Conventional Obturator. (A) Frontal view, (B) Palatal view.

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  Fig. 7 Making the hollow portion of the obturator. (A) Drawing the portion to grind, (B) Hollow potion of the obturator.

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  Fig. 8 Resin curing after packing the empty space with sugar. (A) Sugar packed inside the bulb, (B) Resin curing the open space of the bulb.

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  Fig. 9 Wash out the sugar packed inside the bulb. (A) The hole on the palatal side, (B) Wash out the sugar with hot water using the syringe.

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  Fig. 10 Comparison of the obturator weight. (A) The weight of the conventional obturator, (B) The weight of the closed hollow obturator.

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