Rehabilitation of maxillary defect with cast partial obturator: case report
Journal name: World Journal of Pharmaceutical Research
Original article title: Rehabilitation of acquired maxillary defect with cast partial obturator-a case report
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Dr. Mitali Majumder and Dr. Debashis Mistry
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Rehabilitation of acquired maxillary defect with cast partial obturator-a case report
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20236-27828
Copyright (license): WJPR: All rights reserved
Download the PDF file of the original publication
Summary of article contents:
Introduction
Rehabilitation of maxillofacial defects poses significant challenges to prosthodontists, particularly when it comes to restoring comfort, function, and aesthetics to patients. Acquired defects, often resulting from the resection of neoplasms in the palate, can severely impair masticatory function, cause hypernasal speech, and lead to fluid leakage into the oral cavity. This case report discusses the fabrication of a cast partial obturator used to rehabilitate a patient who developed a palatal defect following surgical intervention for neoplastic growth.
The Role of the Obturator
The term "obturator" is derived from the Latin verb "obturare," meaning to close or shut off, and refers to a prosthesis utilized to close palatal defects. These prostheses re-establish the oro-nasal partition, essential for adequate mastication, deglutition, articulation, and biometric support. The design and configuration of the obturator vary greatly depending on the defect's size, the characteristics of the surrounding tissue, and functional requirements for retention and stabilization. The classification of obturators includes surgical, interim, and definitive types depending on the phase of maxillofacial rehabilitation.
Case Presentation and Fabrication Steps
The presented case involved a 45-year-old female patient who required a definitive obturator after six months of healing from surgery that removed a neoplasm from her palate. Initial treatment involved the use of a surgical obturator. The fabrication process entailed a meticulous set of steps, starting with primary impressions, surveying the maxillary cast, and preparing the mouth. Following these preparations, an impression was taken and a refined metal framework designed, carefully considering principles of removable partial denture design for optimal support and retention.
Importance of Support and Retention
In designing the definitive obturator, a major consideration was support from the remaining palatal tissues and teeth. The framework maximized distribution of support through the incorporation of existing teeth, ensuring that occlusal forces were directed appropriately to mitigate dislodging. This case employed an antero-posterior palatal strap, which distributed forces evenly and enhanced stability. The choice to use a conventional obturator, rather than a hollow bulb, was attributed to the limited extent of the defect, which supported effective rehabilitation without the additional complexity.
Conclusion
This case emphasizes the complexities and considerations involved in prosthodontic rehabilitation of maxillofacial defects. A multidisciplinary approach is essential to navigate the unpredictable nature of defects and their potential recurrence. The use of a definitive cast partial obturator markedly improved the patient’s quality of life, underscoring the importance of tailoring prosthetic solutions to individual needs while adhering to foundational design principles for optimal outcomes.
FAQ section (important questions/answers):
What is the purpose of an obturator in prosthodontics?
An obturator is a prosthetic device used to close a palatal defect, thereby restoring functions such as mastication, deglutition, and speech while improving aesthetics and quality of life.
How are maxillofacial defects categorized?
Maxillofacial defects can be congenital, developmental, or acquired due to accidents, surgeries, or pathologies, with most acquired defects arising from surgical resections of neoplasms in the palate.
What steps are involved in creating a definitive obturator?
The process includes making primary and secondary impressions, surveying casts, fabricating a wax pattern, casting the framework, and adjusting and finishing the prosthesis before insertion.
Why is a definitive obturator made after complete healing?
A definitive obturator is made once the defect has fully healed, usually after 3-6 months, ensuring proper fit and function and accommodating changes in the supporting tissues.
What type of framework was used in the described case?
The case utilized a cast partial metal framework with an antero-posterior palatal strap major connector, I bar clasp, and embrasure clasps for stabilization and retention.
How does a patient care for their obturator?
Patients should maintain proper oral hygiene, clean the obturator regularly, and attend follow-up appointments to ensure the prosthesis fits well and functions appropriately.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Rehabilitation of maxillary defect with cast partial obturator: case report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Post:
'The post' indicates the period after surgery, marking a critical phase in the treatment journey. This term signifies the crucial follow-up necessary to witness healing and evaluate the success of the interventions. 'The post' phase is essential for assessing patients' integration of prosthetic devices into their lives.
2) Bengal (Bemgal):
In this document, 'Bengal' refers specifically to the Indian state of West Bengal, where the authors are associated with various dental institutions. This geographical reference highlights the local context of the case study, denoting where the clinical practices and methodologies are applied in the rehabilitation of patients with maxillary defects.
3) Quality:
'The quality' highlights a definitive standard or measure in the context of the care provided. It emphasizes the evaluation of procedures and interventions utilized to ensure that those undergoing maxillofacial rehabilitation receive optimal treatment that meets specific therapeutic and aesthetic goals, fundamentally impacting their recovery and satisfaction.
4) India:
'India' functions as the broader geographical and cultural context in which the study is situated. Acknowledging the nation establishes delineation of healthcare practices and standards prevalent within it, helping to contextualize the findings and methodologies described in the article, which reflect local health challenges and solutions in dental prosthodontics.
5) Life:
'Life' in this text refers to the patient's overall well-being and daily experiences post-rehabilitation. Restoring 'Life' through prosthetic means connects the medical practice to personal outcomes, highlighting that successful rehabilitation not only fixes physical issues but also allows individuals to engage more fully in their day-to-day activities.
6) Arrangement:
'Arrangement' may refer to the organization and positioning of artificial teeth within a prosthesis. This term stresses the importance of careful planning and execution in dental prosthetics, ensuring that functional and aesthetic functionalities are achieved, mimicking natural teeth, and enhancing both chewing ability and appearance.
7) Discussion:
'Discussion' embodies a critical analysis component within the article, providing insight into the implications of the rehabilitation techniques employed. It also facilitates deeper understanding among readers regarding the rationale behind certain practices, challenges faced, and potential improvements, fostering a collaborative approach to issues encountered in maxillofacial prosthetics.
8) Hygiene (Hygienic):
'Hygiene' emphasizes the necessary maintenance and care required by dental prosthetics to ensure healthy oral conditions. Upholding 'Hygiene' is essential in preventing complications such as infections or additional dental issues, ultimately influencing the longevity and effectiveness of the rehabilitation outcome, underscoring the patient's responsibility post-treatment.
9) Nature:
'Nature' refers to the inherent characteristics and complexities associated with maxillofacial defects. Understanding 'Nature' helps practitioners appreciate variability in defects and tailor interventions accordingly, making it critical in adopting appropriate treatment strategies to optimize rehabilitation for patients with distinct needs and conditions.
10) Medium:
'Medium' refers to the materials used in the prosthetic fabrication process. This term stresses the importance of selecting appropriate materials that enhance functionality, aesthetics, and comfort for the patient. The effectiveness of the rehabilitation can significantly depend on the quality and properties of the 'Medium' utilized in device construction.
11) Visit:
'Visit' denotes a singular appointment for evaluating the patient's condition following the fitting of a prosthesis. Each 'Visit' plays an important role in gauging patient satisfaction and prosthetic functionality, which informs further adjustments or interventions required, ensuring a high standard of care is maintained throughout the rehabilitation process.
12) Study (Studying):
'Study' refers to the research or clinical exploration conducted to understand and improve methods for rehabilitating patients with maxillofacial defects. This comprehensive 'Study' encompasses insights from real case scenarios, allowing practitioners to refine techniques and enhance patient outcomes through evidence-based approaches in dental prosthodontics.
13) Dhar:
'Dhar' mentions a specific place within West Bengal where one of the authors works. This geographic mention is crucial as it situates the research within a defined locale, illustrating the community context and perhaps indicating the regional challenges and practices encountered in the field of prosthodontics in India.
14) Food:
'Food' within this article addresses the fundamental aspect of the patient's daily activities affected by their condition. Restoring the patient's ability to consume 'Food' significantly contributes to their quality of life, making it imperative for the rehabilitative efforts to consider dietary implications by focusing on functional prosthetic solutions.
15) Anta (Amta):
'Amta' refers to a location within West Bengal where one of the authors is associated with a health institution. Identifying 'Amta' anchors the case study within a particular community context, which is valuable for understanding local healthcare dynamics and accessing resources relevant to the practices discussed in the article.
16) Seat (Seated):
'Seat' refers to the positioning of the prosthetic device within the oral cavity. Proper 'Seat' ensures stability, comfort, and effectiveness of the prosthesis, illustrating the technical considerations that go into designing dental solutions. A well-seated prosthesis is fundamental for restoring function and supporting the aesthetic needs of the patient.
Other Science Concepts:
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