![]() ![]() One approach to making the primary impressions for an obturator is to place some impression compound into a stock tray, and to use the compound to record the extent of the palatal defect bucco/palatally and mesial/distally. At this stage, it is not crucial to record the undercuts within the defect as these can be more accurately recorded at the master impression stage. However, if present, the primary impression should record the standing teeth, residual tuberosities, remaining hard/soft palate and the extent of the resection site. The denture-bearing area will depend on the tumour and the extent of the resection site. If the patient has significantly limited opening, a two-part impression technique (and obturator design) may have to be considered.Īs with any conventional prosthesis, the primary impression should record the entire denture-bearing area such that an appropriate special tray can be made. 4 The restorative dentist should examine the patient extra-orally to look for any facial asymmetry, mandibular displacement and trismus. However, this period of surgical healing will clearly differ between patients. Construction of a one-part hollow bulb obturatorĪ period of 6 months may be required (post-resection) before the definitive obturator can be constructed. The authors hope that it will be useful for clinicians who are new to the subject and are making their first obturators. This third article in our series will discuss the clinical stages involved in making a definitive, acrylic resin, one-part hollow box obturator to restore a hard palate defect. However, this will require careful planning and a high degree of surgical skill. 2, 3 For patients who will have a significant maxillary defect or are due to have radiotherapy post resection, the placement of zygomatic or dental implants at the time of ablative surgery may be advantageous to help retain the future prosthesis. 1Ĭonventional rehabilitation with an obturator may be a treatment requirement for some oncology patients post-surgical resection. Significant improvement in the quality of life is achieved after constructing the prosthesis, as it restores the partition between the nasal and the oral cavities, improves mastication, swallowing, speech, dental aesthetics and facial support. If it is not possible to close the resection site surgically, the provision of an obturator is obligatory. Ideally, a flap with vascularized bone should be used as this will optimize the future prosthetic bearing area. Advances in microvascular surgery and the use of free flaps have allowed many oncology patients (with palatal tumours) to undergo resection and immediate reconstruction. ![]()
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