Mani Uma Maheswari, Mohamed Kasim, Krishna Kumar Arjun, Inbarajan Athiban
Department of Prosthodontics,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India.
Spec Care Dentist. 2019 Nov;39(6):610-616. doi: 10.1111/scd.12423. Epub 2019 Oct 14.
Maxillectomy performed in acquired lesions is often very extensive or bilateral, sparing very less hard and soft tissue in the oral cavity. These defects need both surgical and prosthetic rehabilitation. A definitive prosthesis is inserted after complete healing, when the patient is accustomed to the interim prosthesis. Definitive obturator warrants better retention and stability and needs a meticulous planning in design for long-term use. Conventional design has a few disadvantages; it needs modification many times to improve retention and psychological comfort of the patient. The article explains an easy technique in fabrication of an obturator. The conventional obturator design has a hollow antral part but usually a solid oral part, which adds to the weight of the prosthesis pressurizing the soft tissues in a maxillectomy, which affects the function and esthetics. This article demonstrates the hollowing of oral part, which bears the artificial teeth, and modifying the antral bulb, which covers the defect. It was designed considering the potential difficulties shared by the patient in wearing the single piece conventional hollow bulb design. This technique when followed was beneficial in reducing the weight of the prosthesis and enhancing retention, and allowed the patient to perform normal functional movements.
后天性病变行上颌骨切除时，手术范围通常非常广泛或为双侧，口腔内保留的软硬组织极少。这些缺损需要手术和修复重建。在伤口完全愈合后，患者适应了临时修复体时，再植入最终修复体。最终的阻塞器固位和稳定性更好，设计时需要精心规划以确保长期使用。传统设计存在一些缺点；需要多次修改以提高固位力和患者的心理舒适度。本文介绍了一种制作阻塞器的简便技术。传统阻塞器设计的上颌窦部分为中空，但口腔部分通常为实心，这增加了修复体的重量，对上颌骨切除术后的软组织造成压力，影响功能和美观。本文展示了承载人造牙的口腔部分的中空处理，以及覆盖缺损的上颌窦球状物的改良。设计时考虑到了患者佩戴单片传统中空球状物设计可能遇到的困难。采用该技术有助于减轻修复体重量、增强固位力，并使患者能够进行正常的功能活动。
