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A restricted mouth opening in hemimaxillectomy patients can create a signifi cant problem with insertion and removal
of the obturator prosthesis. A two-piece obturator is an alternative management for such patients. The treatment of
a patient with a hemimaxillectomy due to squamous cell carcinoma is presented in this clinical report. A sectional
ob...
Citations
... There are methods that fabricate a hollow bulb by using various materials and techniques. [4,5] Silicone liners, which are flexible or resilient, allow bone undercuts to be engaged, offering more comfort and stability without compromising retention. [6][7][8] Magnets are used for retention because of their small size and strong attractive forces, attributes that allow them to be placed within prostheses without being obtrusive in the mouth. ...
Mucormycosis has recently become more common in India, with COVID-19 patients being the most affected. Pulmonary, gastrointestinal, disseminated, or rhinocerebral infections have various forms of mucormycosis. The most prevalent type is rhinocerebral, which affects the maxilla, nose, sinuses, and brain. A total or partial maxillectomy has an impact on a patient's cosmetic, functional, and psychological well-being. To replace not only missing teeth but also lost soft tissues and bone, such as the hard palate and alveolar ridges, a maxillofacial prosthodontist must overcome numerous obstacles. For the rehabilitation of such deformities, prosthetic rehabilitation has become the preferred option. Magnets are an efficient technique to provide retention, quality, and consistency in a system. This clinical report describes the prosthetic rehabilitation of an acquired maxillary defect secondary to mucormycosis with a magnet-retained two-part prosthesis.
... This necessitates a second surgery for implant placement after complete remission. The cost of treatment is also essential because of the high rate of recurrence and multiple surgeries [8]. ...
Mucormycosis is an aggressive opportunistic fungal infection that affects blood supply-rich areas such as the maxilla. Because of the compromised immune system caused by coronavirus disease 2019 (COVID-19) infection and diabetes, this infection has spread at a rapid rate. Early detection and treatment can reduce disease mortality and morbidity. However, the difficulties of prosthetic rehabilitation and the lack of multidisciplinary planning negatively influence the quality of life (QOL). This case report uses the novel concept of magnet-retained immediate prosthetic rehabilitation in such a case.
... Gupta et al. [13] in their case report on restricted mouth opening described inflatable obturator as treatment option, but the problem with this technique is it required each time to inflate the obturator after insertion to cover the defect. Deogade and Mantri [14] in their case report described sectional obturator prosthesis retained by magnets in restricted mouth opening case. The drawback of this technique is extra cost for magnets and also there may be corrosion and further loss of magnetism after some times and need replacement of magnets. ...
Eradication of head and neck carcinoma with surgical resection usually leave behind the
patient with a large tissue defect and to rehabilitate such patients to optimum function
and esthetics is a challenging task for the maxillofacial prosthodontist. The patients
undergoing partial or total maxillary resections have difficulty in mastication, swallowing,
speech, and social interaction. This article presents a case report of a hemimaxillectomy
patient treated with a two‑piece hollow acrylic bulb obturator. This case report presents
a modified impression technique with a specially designed sectional tray as the patient
had reduced mouth opening. The prosthesis improves the hypernasality, mastication,
and speech of the patient.
Purpose:
Patients with maxillofacial defects secondary to the removal of benign and malignant pathologies of midface have a profound impact on quality of life. The aim of this study was to collect and analyze the data pertaining to 4 designs of obturator by assessment of the patient with obturator functioning scale (OFS) MATERIALS AND METHODS:: This retrospective analysis included all the patients who underwent prosthetic rehabilitation of maxillary defects using 4 different types (conventional, cast partial, hollow bulb, and magnet retained) of obturators from 2009 to 2016 with minimum 1 year of follow up. Demographics, number, size, location, type of pathology, postmorbid dentition, and the treatment rendered were recorded. Obturator functioning scale was used to subjectively assess the patient satisfaction.
Results:
The mean score on OFS was 5.67 (standard deviation: 1.8). There was a fair and statistical improvement in chewing/eating, speech clarity in public/on phone, swallowing of foods and liquids, pronunciation of words, and social interaction (P < 0.05). The outcome was best in magnet retained followed by cast partial group. The least outcome was in conventional obturator group.
Conclusion:
Obturators of different designs do play an important role in rehabilitation of maxillary defects with a satisfactory outcome.
Patient
A 21-year-old female patient was diagnosed with intraosseous mucoepidermoid carcinoma on the left side of maxilla, which was planned for subtotal maxillectomy involving the left maxillary sinus.
Discussion
Prosthodontic rehabilitation of patients with maxillectomy is a challenge as it involves restoring speech, deglutition, mastication and respiration. This clinical report describes a comprehensive prosthodontic management of a young girl treated for a subtotal maxillectomy due to intraosseous mucoepidermoid carcinoma. The prosthodontic manage- ment that was carried out right from the surgical obturator to a definitive prosthesis with a two-piece closed hollow bulb, magnet-retained obturator shows the ease and simplicity in the management of a case with subtotal maxillectomy.
Conclusion
Subtotal maxillectomy defects represent a complex challenge for the maxillofacial prosthodontist. The comprehensive technique described in this clinical report can be employed in any similar case.
How to cite this article
Sundar MK, Kumar GPS, Lakhanpal S. A Comprehensive Prosthodontic Management of Subtotal Maxillectomy. Int J Prosthodont Restor Dent 2014;4(4):120-126.
