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Year : 2016  |  Volume : 8  |  Issue : 8  |  Page : 874-878

Silicone Obturator with Reduced Bulb Extension: Enhancing Quality of Life in Post-surgical Maxillectomy Defect

1 Post-graduate Student, Department of Prosthodontics and Crown and Bridges, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India
2 Professor and Head, Department of Prosthodontics and Crown and Bridges, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India

Correspondence Address:
Angel Mary Joseph
Department of Prosthodontics and Crown and Bridges, Pushpagiri College of Dental Sciences, Medicity, Perumthuruthy, Tiruvalla - 689 107, Kerala, India

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Source of Support: None, Conflict of Interest: None

DOI: 10.2047/jioh-08-08-08

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The essence in cancer care has shifted from mere "survival" to "rehabilitation," which aims to improve multiple impairments and quality of life. Head and neck cancers constitute one of the most devastating forms of cancer resulting in maxillofacial defects. Rehabilitation of acquired maxillofacial defects is accomplished either by surgical or prosthodontic rehabilitation. The goal of prosthetic rehabilitation is to obturate the defect, allowing for optimum esthetics and function. However, this has remained as a challenging process due to the lack of adequate retention, stability, and support of the prosthesis. This study presents a simplified approach to rehabilitate an extensive maxillectomy defect secondary to surgical resection in a patient with the limited oral opening. The patient had undergone left hemimaxillectomy for squamous cell carcinoma of the left alveolus 7 days back. The patient did not have a surgical obturator and required prosthesis to restore the lost teeth and function. The treatment plan initially was to improve the mouth opening using screw gag prosthesis to facilitate the clinical steps, and then rehabilitate the defect using interim obturator prosthesis. Some modifications in the impression procedure like the use of modified stock trays and sectional custom trays also aided in obtaining adequate impressions. The obturator comprised silicon obturator with reduced bulb extension and heat cure acrylic denture base which were attached using cyanoacrylate adhesive. Different design features have been incorporated into the design to achieve adequate prosthesis retention, support, and stability. Post-insertion instructions were given to the patient and were scheduled on a regular recall protocol to evaluate the fit and functioning of the prosthesis Post-insertion results showed improvement in speech, mastication, swallowing, and facial aesthetics. The primary objectives of maxillofacial prosthetic rehabilitation were achieved with this novel design contributing to enhancement of quality of life of the cancer patient.

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