Alani A, Owens J, Dewan K, Summerwill A. A national survey of oral and maxillofacial surgeons' attitudes towards the treatment and dental rehabilitation of oral cancer patients. Br Dent J. 2009; 207:540-541
Aramany MA. A history of prosthetic management of cleft palate: Pare to Suersen. Cleft Palate J. 1971; 8:415-430
Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: Classification. J Prosthet Dent. 2001; 86:559-561
Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol. 2010; 11:1001-1008
Parr GR, Tharp GE, Rahn AO. Prosthodontic principles in the framework design of maxillary obturator prostheses. J Prosthet Dent. 2005; 93:405-411
Aramany MA. Basic principles of obturator design for partially edentulous patients. Part II: Design principles. J Prosthet Dent. 2001; 86:562-568
Devlin H, Barker GR. Prosthetic rehabilitation of the edentulous patient requiring a partial maxillectomy. J Prosthet Dent. 1992; 67:223-227
Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW Quality of life of maxillectomy patients using an obturator prosthesis. Head Neck J Sci Specialties Head Neck. 1996; 18:323-334
Sharma AB, Beumer J. Reconstruction of maxillary defects: the case for prosthetic rehabilitation. J Oral Maxillofac Surg. 2005; 63:1770-1773
Walter J. Obturators for acquired palatal defects. Dent Update. 2005; 32:277-284
Irish J, Sandhu N, Simpson C, Wood R, Gilbert R, Gullane P Quality of life in patients with maxillectomy prostheses. Head Neck J Sci Specialties Head Neck. 2009; 31:813-821
Nadeau J. Maxillofacial prosthesis with magnetic stabilizers. J Prosthet Dent. 1956; 6:114-119
Beumer III, Curtis TA, Marunick MT.St Louis, Toronto, London: The CV Mosby Co; 1979
Rehabilitation of oncology patients with hard palate defects part 2: principles of obturator design Rahat Ali Asmaa Altaie Brian Nattress Dental Update 2024 42:5, 707-709.
The first part of this series on the conventional rehabilitation of oncology patients with hard palate defects discussed the dental challenges posed by oncology patients and the surgical/restorative planning interface for conventional dental rehabilitation. This article will describe Aramany's classification of hard palate defects, Brown's classification of palatal defects and focus on the basic principles of obturator design which need to be appreciated when prosthetically rehabilitating a patient with a hard palate defect.
CPD/Clinical Relevance: A good understanding of basic removable prosthodontic theory relating to denture design, dental materials science and head and neck anatomy is a prerequisite when designing an obturator for a patient.
Article
Resecting a palatal tumour will result in a surgical defect. The resulting defect can be managed by primary surgical closure, reconstruction with a surgical flap or prosthetic obturation. The decision as to which modality of treatment is chosen should be made within an oncology multidisciplinary team with input from surgeons, clinical oncologists, radiologists and restorative dentists.1 With modern surgical techniques, it is encouraging to see that more surgeons are offering reconstructions for head and neck oncology patients post resection.
The use of microvascular flaps to reconstruct head and neck cancer patients has increased over the years, with deep circumflex iliac artery (DCIA) and radial forearm free flaps (RFFF) being used to reconstruct maxillary defects.2 It is encouraging to see that the use of dental implants to rehabilitate oral cancer patients has also increased since 1995.2 There is, however, a cohort of patients who have not been reconstructed and may be unsuitable for, or may not be interested in, implant-based rehabilitation. Such patients with acquired hard palate defects will need conventional dental rehabilitation with an obturator. For these patients, the obturator will help to separate the oral and nasal cavities, help to restore normal speech and swallowing and provide support for the lip and cheek.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
