Reconstruction of the maxillectomy with an obturator is to restore masticatory, swallowing, phonetic and esthetic problems. Stress created by lateral forces is minimized by the proper selection of an occlusal scheme, elimination of premature occlusal contacts, and wide distribution of supporting area. It should be considered that properly designed retainers reduce the stresses transmitted to the abutment while the obturator is in function. The following clinical report presents palatal obturator treatment with implant assisted removable partial denture (IARPD) design that restores normal function and esthetics in patients who experienced maxillectomy and dental implant failure.
Deglutition ; Dental Implants ; Denture, Partial, Removable ; Esthetics ; Humans ; Palatal Obturators

OBJECTIVETo evaluate the effect of a system of velopharyngeal incompetence (VPI) management after the application of obturator.

METHODSUsing nasopharyngofiberoscope (NPF) and a computer analysis system, we quantitatively analyzed the improved state of velopharyngeal incompetence in 100 patients with unilateral and/or bilateral cleft palate.

RESULTSThe velopharyngeal closure (VPC) can be greatly improved by using a temporary oral prosthesis (obturator) and speech training. An objective quantitative standard was established to evaluate the change of velopharyngeal closure of cleft palate patients after surgery and conservative treatment.

CONCLUSIONSThe method used is more succinct, accurate and practical than previous methods. In order to reflect the state of velopharyngeal incompetence, the concept of improvement rate of velopharyngeal incompetence (IRVPI) is put forward.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Infant ; Palatal Obturators ; Velopharyngeal Insufficiency ; therapy

The closed palate and obturator prostheses with bar clasp and attachment retention were designed and modeled for repairing the unilateral defect maxillary, and then they were analyzed using finite element method. Under simulated muscle restriction and masticating force boundary, the strength of four maxillary prostheses, the attachment, base plate, bar clasp, denture, obturator et cetera, were considered, and the stress dimension and tendency of the rest living teeth and prostheses were studied. According to the studies on stress, the optimized structure and biomechanical evaluation have a role in the repairs to maxillary defect. The results of analysis are as follows: The stresses of each part of the prostheses were all in the strength range of the materials. The stress distribution on the rest living teeth and alveolar bone was reasonable; the biting force was effectively transferred by the prostheses. As to the obturator prostheses, the materials properties were similar to those of alveolar bone or a bit lower than those, and the obturator structure filled in the cavum of maxillary bone to increase the touch area in the structure was more reasonable than the palate closed structure. The stress and displacement results of living teeth showed that the attachment retention and obturator prostheses could avoid the stress concentration on living teeth and could benefit the retention and power support.
Biomechanical Phenomena ; Denture, Partial, Removable ; Humans ; Maxilla ; abnormalities ; surgery ; Palatal Obturators

A 3-month-old Schnauzer was presented with congenital defects of the secondary palate. On the clinical examination, coughing, sneezing, drainage of nasal discharge from the external nares and poor growth were found. Vital signs and results of blood examination were within normal ranges. Thoracic radiography revealed mild pneumonia in the right lung lobes. In a puppy suffering from cleft palates, a palatal prosthesis was applied to the hard palate in order to protect the surgical wound, because a routine surgery was not successful. A palatal prosthesis was applied and held in place using the instant glue and plastic bands to protect the surgical wound following the third repeated surgery. Although a small oronasal fistula still remained, there was no functional defect. This prosthesis was easy to apply and helpful to protect the surgical wound. In addition, this implant could be placed or adjusted without or sedation/anesthesia.
Animals ; Cleft Palate/surgery/*veterinary ; Dog Diseases/congenital/*surgery ; Dogs ; Male ; Palatal Obturators/*veterinary

Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.
Cleft Lip ; Cleft Palate* ; Congenital Abnormalities ; Deglutition ; Humans ; Mastication ; Mouth ; Nasal Cavity ; Palatal Obturators* ; Palate ; Palate, Soft ; Velopharyngeal Insufficiency*

Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth.
Braces ; Crowns ; Denture Precision Attachment ; Female ; Humans ; Maxilla ; Melanoma ; Middle Aged ; Palatal Obturators ; Prognosis ; Prostheses and Implants ; Tooth

Oral mucormycosis is a fungal infection observed mainly in elderly immunocompromised patients. In rare instances, the disease occurs in healthy individuals and those patients that are below preschool age. Although this condition mainly involves the maxilla, it may also manifest in any part of the oral cavity based on the source of infection. Mucormycosis of the maxilla spreads rapidly, leading to necrosis of the palatal bone and palatal perforation. Such patients are usually rehabilitated using bone grafting or free flap surgeries. However, when surgeries are delayed, palatal prosthesis is an interim treatment modality that can prevent nasal regurgitation and aspiration of food or fluids. Palatal prostheses also help with mastication, speech, and swallowing. The present case describes a rare case of oral mucormycosis in an 18-month-old male involving the maxilla that was managed by palatal prosthesis.
Aged ; Bone Transplantation ; Child* ; Deglutition ; Free Tissue Flaps ; Humans ; Immunocompromised Host ; Infant* ; Male ; Mastication ; Maxilla ; Mouth ; Mucormycosis* ; Necrosis ; Palatal Obturators ; Prostheses and Implants

This clinical report described the oral rehabilitation of a cleft lip and palate patient with removable partial denture. Although implant-supported fixed treatment was presented as part of the optimum treatment plan to achieve the best result, the patient declined this option due to the significant financial burden. Persons with a congenital or craniofacial defect are unique, and oral problems must be evaluated individually to the most ideal treatment. The changes in appearance, function, and psychological wellbeing have an enormous impact on patients' personal lives and are rewarding for the maxillofacial prosthodontist providing this care.
Cleft Lip/*rehabilitation ; Cleft Palate/*rehabilitation ; Dentistry/methods ; Denture Design ; Denture, Overlay ; *Denture, Partial, Removable ; Female ; Humans ; Middle Aged ; Palatal Obturators

PURPOSE: The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS: This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS: Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION: The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required.
Congenital Abnormalities ; Female ; Head and Neck Neoplasms ; Humans ; Insurance ; Korea* ; Male ; Mandibular Prosthesis ; Maxillofacial Prosthesis ; Palatal Obturators ; Palate, Hard ; Prosthodontics ; Rehabilitation ; Retrospective Studies ; Specialization ; Velopharyngeal Insufficiency

OBJECTIVETo evaluate the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velopharyngeal closure under the lateral radiography.

METHODSThe lateral radiographs and cephalometric analysis were taken in sixty-two patients with cleft palate and velopharyngeal insufficiency, 32 repaired with velopharyngeal muscular reconstruction and 30 with modified von Langenbeck's procedure (non-reconstructive group).

RESULTSIn patients with velopharyngeal muscular reconstruction, the velopharyngeal competence, the reductive rate of nasopharynx, the distance reduction in lower part of the mobile nasopharynx during phonation and the distance in middle part of mobile nasopharyngo in rest were superior to that without velopharyngeal muscular reconstruction, and there were variform PPW eminence-soft palate contact in velopharyngeal closure. The patients with complete or good velopharyngeal closure had a definite reduction in nasopharynx, compared to the patients with velopharyngeal insufficiency in the non-reconstructive group.

CONCLUSIONSThe functional area for velopharyngeal closure after palatoplasty might be located in the middle part of mobile nasopharynx. The velopharyngeal muscular reconstruction in palatoplasty could reduce the size of nasopharynx and improve the coordination movement of velopharyngeal closure.

Adolescent ; Adult ; Child ; Child, Preschool ; Cleft Palate ; surgery ; Humans ; Laryngeal Muscles ; surgery ; Palatal Obturators ; Reconstructive Surgical Procedures ; methods ; Velopharyngeal Insufficiency ; surgery ; Young Adult