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Saadellaoui I, Bekri S, Labidi A, Yaala MB, Mabrouk Y, Mansour L. Combination of CAD/CAM technologies and conventional processing in the fabrication of a maxillary obturator prosthesis: a clinical report. J Med Life 2024; 17:375-380. [PMID: 39044932 PMCID: PMC11262598 DOI: 10.25122/jml-2024-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/10/2024] [Indexed: 07/25/2024] Open
Abstract
Soft and hard tissue defects resulting from resective surgeries for carcinomas located in the maxillary arches can cause functional, esthetic, and psychological damage. A removable obturator prosthesis offers several advantages, restoring oral functions and improving patients' quality of life. Technological advancements, such as the use of intraoral scanning and computer-aided design (CAD) and manufacturing, reduce laboratory working time, eliminate the risk of impression material aspiration, and address challenges related to whole tissue undercut impression. Here, we report the case of a partially edentulous female patient with a velo-palatal defect for whom a rigid maxillary obturator prosthesis was fabricated. Digital impressions were taken and the standard tessellation language files of the scans were sent to the laboratory. Using dental CAD software, the maxillary metallic framework was designed and manufactured using selective laser melting technology. The obturators and artificial teeth were conventionally processed, with acrylic resin used for the rigid obturators. The resulting obturator prosthesis made it possible to close the oro-nasal communication and to improve swallowing, speaking, and chewing.
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Affiliation(s)
- Ines Saadellaoui
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Sana Bekri
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Amel Labidi
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Mohamed ben Yaala
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Yosra Mabrouk
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Lamia Mansour
- Department of Removable Prosthodontics, Approche Biologique et Clinique Dento-Faciale (LR12ES10) Laboratory, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
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Ebersole BM, McMillan H, Hutcheson K. Evaluation and Management of Speech and Swallowing Issues in RFS. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
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Naveau A, Kret M, Plaire V, Delorme O, Marchi S, de Bataille C, Destruhaut F, Arrive E, Bou C. Efficacy of a new membrane obturator prosthesis in terms of speech, swallowing, and the quality of life of patients with acquired soft palate defects: study protocol of the VELOMEMBRANE randomized crossover trial. Trials 2022; 23:221. [PMID: 35303932 PMCID: PMC8931575 DOI: 10.1186/s13063-022-06163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life. Methods The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC). Discussion High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency. Trial registration ClinicalTrials.govNCT04009811. Registered on 4 July 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06163-6.
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Affiliation(s)
- Adrien Naveau
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France. .,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France. .,INSERM, Bio-ingénierie Tissulaire BioTisU1026, 33076, Bordeaux Cedex, France.
| | - Marion Kret
- CHU de Bordeaux, USMR, Pôle Santé publique, 33076, Bordeaux, France
| | - Valérie Plaire
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France
| | | | | | - Caroline de Bataille
- Université de Toulouse, Faculté de Chirurgie Dentaire, 31062, Toulouse, France.,CHU de Toulouse, Hôpital de Rangueil, 31059, Toulouse Cedex, France
| | - Florent Destruhaut
- Université de Toulouse, Faculté de Chirurgie Dentaire, 31062, Toulouse, France.,CHU de Toulouse, Hôpital de Rangueil, 31059, Toulouse Cedex, France.,Evolution and Oral Health Laboratory (EvolSan), Paul Sabatier University, Toulouse, France
| | - Elise Arrive
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France.,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France
| | - Christophe Bou
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33000, Bordeaux, France.,Université de Bordeaux, UFR des Sciences Odontologiques, 33076, Bordeaux, France
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