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Tasopoulos T, Naka O, Tampakos I, Kouveliotis G, Zoidis P. A fully digital approach to replacing an obturator prosthesis using a 3D printed closed hollow bulb: Α dental technique. J Prosthet Dent 2024:S0022-3913(24)00195-1. [PMID: 38556405 DOI: 10.1016/j.prosdent.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 04/02/2024]
Abstract
The replacement of an obturator prosthesis using conventional methods has multiple issues. Standard tessellation language files generated from the superimposition of an accurate intraoral scanning of the maxillary defect and direct data acquisition of the existing hollow bulb obturator can facilitate the precise design of the prosthesis, requiring only minor adjustments. Rapid prototyping manufacturing techniques seem to ensure precise control of the integrity of the prosthetic component completion. The success of the technique is the simplicity and repeatability of designing and fabricating a retrievable and easily repairable obturator.
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Affiliation(s)
| | - Olga Naka
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - George Kouveliotis
- Assistant Professor, Division of Prosthodontics, Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Fla
| | - Panagiotis Zoidis
- Professor, Division of Prosthodontics, Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Fla; Associate Dean, Clinical Affairs and Quality, University of Florida College of Dentistry, Gainesville, Fla.
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2
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Sharaf MY, Eskander AE. Patient Satisfaction regarding Conventional One-Piece Versus Two-Piece Magnet-Retained Obturator for Patients with Complete Edentulism: A Preliminary Crossover Clinical Trial. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
This study aimed at evaluating patients' satisfaction with conventional one-piece obturators versus two-piece magnet-retained obturators in completely edentulous patient maxillectomy cases.
Materials and Methods:
Ten completely edentulous participants with hemimaxillectomy (8 males and 2 females) were selected in a crossover study. Participants received a conventional obturator one-piece and two-piece obturators connected by magnet attachment in alternate periods (sequences A‐B and B‐A), and outcomes were assessed after 1 week, 3 months, and 6 months Evaluation was made using Obturator Functioning Scale (OFS) and Oral Health Impact Profile for edentulous people (OHIP-EDENT). One way ANOVA test and multivariate analysis of variance with a general linear model with repeated measures was used to test the impact of the group, time, and order on each of the studied scores (α=.05).
Results:
Magnet design showed a statistically significant lower score (P <.050) than the conventional design regarding the overall satisfaction score of OFS along all follow-up periods. Concerning OHIP-EDENT, the magnet design showed a statistically significant lower score (P <.050) than the conventional design regarding total functional limitations, total physical pain, and total social disability along all follow-up periods while for total psychological discomfort, total physical disability, and total handicap, no statistically significant difference was observed between both groups (P >.050).
Conclusion:
Two-pieces magnet-retained obturator could provide better satisfaction and better restoration of orofacial function than the conventional one to manage completely edentulous patients.
Clinical Trial Registration Number:
NCT05066828
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Sharaf MY, Eskander AE. PEEK versus Metallic Attachment-Retained Obturators for Patient Satisfaction: A Randomized Controlled Trial. Eur J Dent 2021; 16:80-95. [PMID: 34814222 PMCID: PMC8890929 DOI: 10.1055/s-0041-1731839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective
The aim of the study was patients’ satisfaction evaluation and radiographic evaluation of the terminal abutments of attachment-retained maxillary obturators with metal framework versus milled polyetheretherketone (PEEK) framework in the management of maxillectomy cases.
Materials and Methods
Eighteen participants were randomly divided into three parallel groups (
n
= 6). Participants of the PEEK group received attachment-retained obturators with milled PEEK framework, the metal group received an attachment-retained obturator with a metallic framework, and the conventional group received conventional clasp-retained obturators with a metallic framework (Control group). The evaluation included was radiographic evaluation and patients’ satisfaction in this study included two scales—”The Obturator Functioning Scale” and “The European Organization for Research and Treatment of Cancer Head and Neck 35” using one-way ANOVA test.
Results
Both PEEK and metal groups showed a statistically significant lower mean bone loss (
p
<0.050) compared with the conventional group during all follow-up periods. There is no statistically significant difference between the PEEK and metal groups during all follow-up periods. Regarding patient satisfaction, both the PEEK and metal groups showed a statistically significant decrease score (
p
<0.050) compared with the conventional group in various aspects of patients’ satisfaction scales as satisfaction with the look and difficulty of talking to the public, and noticeable clasps. In comparison, the PEEK group showed a statistically significant decrease score (
p
<0.050) than the metal group with respect to satisfaction with the look along all follow-up periods.
Conclusions
PEEK attachment-retained maxillary definitive obturators could be considered a promising treatment modality for patients with acquired maxillary defects with regard to esthetics and satisfaction.
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Affiliation(s)
- Mohamed Yahia Sharaf
- Department of Prosthodontics, Faculty of Dentistry, University of Menoufia, Menoufia, Egypt
| | - Asharaf Email Eskander
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, University of Cairo, Cairo, Egypt
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4
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Francis L. Rehabilitation of a Patient with Facial and Palatal Defect - A Case Report. J Clin Diagn Res 2017; 11:ZD19-ZD20. [PMID: 28511525 DOI: 10.7860/jcdr/2017/25063.9540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/13/2017] [Indexed: 11/24/2022]
Abstract
Defects involving the face and maxilla present a challenge to the prosthodontists as these have a direct effect on aesthetics, function as well as the psychology of the patient. An array of problems awaits the clinician from restoring the previous contour of the oral cavity, facial form, etc. to the mental state of the patients. This article deals with the rehabilitation of a hemimaxillectomy patient with a facial defect, using an interim hollow bulb obturator and a silicone facial prosthesis, which helped to improve the general well being of the patient. Rehabilitative procedures provide patients considerable care so that they can continue their life with confidence.
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Affiliation(s)
- Litty Francis
- Former Senior Resident, Department of Prosthodontics, Government Dental College, Thiruvananthapuram, Kerala, India
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5
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Orbital Rehabilitation Implant-Retained. J Craniofac Surg 2016; 27:1916-1917. [DOI: 10.1097/scs.0000000000002940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Singh K, Kumar N, Gupta N, Sikka R. Modification of existed prosthesis into a flexible wall hollow bulb obturator by permanent silicone soft liner for a hemimaxillectomy patient with restricted mouth opening. J Prosthodont Res 2015; 59:205-9. [PMID: 26043890 DOI: 10.1016/j.jpor.2015.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 04/20/2015] [Accepted: 04/23/2015] [Indexed: 11/28/2022]
Abstract
PATIENT A patient of hemimaxillectomy with restricted mouth opening, wearing a hard acrylic bulb obturator encountered difficulty in insertion and removal of the prosthesis. The prosthesis was converted into a open hollow bulb obturator with flexible walls with permanent silicone soft liner for easy insertion and removal. DISCUSSION Patients having acquired maxillary defects due to surgical resection of the maxilla often suffer with difficulty in mastication, swallowing, nasal regurgitation, speech disturbances and poor esthetics. Different types of obturator with various bulb designs most commonly fabricated from acrylic resins together with "acrylic resin plate and/or" metal framework are used to improve the quality of life of these patients by restoring the function. But restricted mouth opening in some of these patients makes it difficult to place and remove the prosthesis with hard acrylic bulb. Fabrication of flexible open hollow bulb and relining of remaining obturator with resilient permanent silicone soft liner makes easy insertion and removal of the prosthesis and also improve the retention by intimate contact of soft liner with the tissues. CONCLUSION Permanent silicone soft liner open hollow bulb obturator is a novel way for the functional rehabilitation of a hemimaxillectomy patient suffering with restricted mouth opening.
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Affiliation(s)
- Kunwarjeet Singh
- Department of Prosthodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India.
| | - Narendra Kumar
- Department of Prosthodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Rohan Sikka
- Department of Prosthodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
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Vaidya S, Parkash H, Gupta S, Bhargava A, Kapoor C. Two-Piece Hollow Bulb Obturator for Postsurgical Partial Maxillectomy Defect in a Young Patient Revamping Lost Malar Prominence: A Clinical Report. J Prosthodont 2015; 25:71-6. [PMID: 25997077 DOI: 10.1111/jopr.12290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 11/29/2022] Open
Abstract
The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical resection of the tumor. Ablative surgery may be followed by a reconstructive phase, in which the surgeon may choose between local flaps, nonvascularized bone grafts or free vascularized flaps to close the surgical site, depending on the general conditions of the patient. Esthetic and functional results are challenging to achieve for the prosthodontist, as variable amount of hard and soft tissues are removed. This report describes the fabrication of a two-piece hollow obturator for a 19-year-old patient who underwent wide surgical excision of the osteosarcoma of the maxilla and was rehabilitated to function. In this case, the surgical site was covered with submental flap, and the second piece of the obturator provided fullness to the lost malar prominence.
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Affiliation(s)
- Sharad Vaidya
- Department of Prosthodontics, Himachal Dental College, Sundernagar, India
| | - Hari Parkash
- Department of Prosthodontics and Implantology, I.T.S.-CDSR, Ghaziabad, India
| | - Sharad Gupta
- Department of Prosthodontics and Implantology, I.T.S.-CDSR, Ghaziabad, India
| | - Akshay Bhargava
- Department of Prosthodontics and Implantology, I.T.S.-CDSR, Ghaziabad, India
| | - Charu Kapoor
- Department of Oral Pathology and Microbiology, Bhojia Dental College and Hospital, Baddi, India
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8
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Choudhury M, Shanmuganathan N, Padmanabhan TV, Swarup S, Grover M, Arumugam M. Rehabilitation of post surgical maxillectomy defects using interim obturators-a case series. Indian J Surg Oncol 2014; 5:315-20. [PMID: 25767349 PMCID: PMC4354841 DOI: 10.1007/s13193-014-0361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 11/17/2014] [Indexed: 10/24/2022] Open
Abstract
Prosthetic rehabilitation of extensive maxillectomy defects are exigent given the difficulties faced due to loss of palatal bone,teeth and surrounding supporting tissues which help in retention, support and stability of the prosthesis. An interim maxillary obturator is a prosthesis which is made after surgical resection of a portion or all of one or both maxilla where initial healing is completed. Frequently many or all teeth in the defect area are replaced by this prosthesis. It plays a vital role in preventing the facial disfigurement and irritation to the surgical site thereby enhancing the healing and restores the functional capabilities such as speech, mastication, deglutition etc. To gain better retention and stability, preservation of the unaffected regions is needed which can be achieved by proper surgical planning and designing of the prosthesis. This case series describes rehabilitation of three extensive maxillectomy defects with hollow open and closed interim obturators.
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Affiliation(s)
- Minati Choudhury
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
| | - N. Shanmuganathan
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
| | - T. V. Padmanabhan
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
| | - Shailee Swarup
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
| | - Manita Grover
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
| | - Mahalakshmi Arumugam
- Department Of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai India
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9
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A direct investment method of closed two-piece hollow bulb obturator. Case Rep Dent 2013; 2013:326530. [PMID: 23936685 PMCID: PMC3710603 DOI: 10.1155/2013/326530] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 06/09/2013] [Indexed: 11/23/2022] Open
Abstract
Maxillary defects occur due to surgical treatment of benign and malignant tumors, congenital malformation, and trauma. Prosthetic rehabilitation in such patients is influenced by the size and location of the defect. The most common of all intraoral defects are seen in the maxilla, in the form of an opening into the maxillary sinus and nasopharynx. These defects create disabilities in speech, deglutition, and mastication. The prosthesis which closes such an opening and recreates the functional separation of the oral cavity and sinus and nasal cavities is referred to as an obturator. Numerous techniques of hollow bulb fabrication have been mentioned in the literature from time to time. But there are only a few methods for bulb fabrication in two-piece obturator. This technique describes a direct investment method of waxed-up closed hollow bulb two-piece obturator.
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Oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator; a clinical report. Case Rep Dent 2013; 2013:190180. [PMID: 23533823 PMCID: PMC3603645 DOI: 10.1155/2013/190180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 02/04/2013] [Indexed: 11/17/2022] Open
Abstract
Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator.
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11
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Abstract
The prosthetic treatments play a role in the rehabilitation of patients with congenital and acquired cleft palate. To prepare the surgical field and/or correct inevitable sequelae of the surgery, the rehabilitation with obturator prosthesis is an auxiliary or complementary treatment to surgical treatments. In cases where the surgical treatment is contraindicated, the prosthetic rehabilitation becomes a definitive treatment. The denture is planned and fabricated according to each patient. Therefore, the aim of this study was to discuss the prosthetic rehabilitation performed in patients with oronasal communication.
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12
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Shimizu H, Yoshida K, Mori N, Takahashi Y. An Alternative Procedure for Fabricating a Hollow Interim Obturator for a Partial Maxillectomy Patient. J Prosthodont 2009; 18:276-8. [DOI: 10.1111/j.1532-849x.2008.00413.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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