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Rehabilitation of oncology patients with hard palate defects part 1: the surgical planning phase Rahat Ali Asmaa Altaie Brian Nattress Dental Update 2024 42:4, 707-709.
This article is the first in a series of three papers that will discuss the conventional non-implant retained prosthodontic rehabilitation of oncology patients with surgically acquired hard palate defects. In this first paper, the dental challenges posed by the oncology patients will briefly be discussed. The interface between the specialist restorative dentist and the maxillofacial surgeon when planning the conventional dental rehabilitation of an oncology patient with a hard palate defect will be discussed in detail.
Clinical Relevance: To highlight the importance of the restorative dentistry/surgical interface when planning a treatment for a patient requiring a maxillectomy and conventional obturation.
Article
Maxillary hard palate defects can be congenital or acquired in nature. Acquired palatal defects can be created by the surgical treatment of benign or malignant tumours. Although head and neck cancers are relatively rare in the UK (with 8000 new cases being reported per year),1 patients who present with such malignancy require careful planning and treatment. If the tumour is managed surgically, this treatment can have major effects on the physical, psychological and social wellbeing of these patients.2 Removal of the palate by ablative surgery creates a significant anatomical defect that allows the oral cavity, maxillary sinus, nasal cavity and nasopharnyx to become one confluent chamber. This has a significant impact on patients in terms of their ability to speak, swallow and chew. Food and liquids will pass from the oral cavity into the nasal cavity, making adequate feeding very difficult. Air escape from the oral cavity into the nasal passages can also create an unnatural hypernasal speech pattern.3 Furthermore, the presence of the defect can constantly (and adversely) remind patients of their experience with cancer. Management of the resected site can be by surgical reconstruction or prosthetic rehabilitation with an obturator.
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