From Volume 42, Issue 7, September 2015 | Pages 612-620
This article will discuss the clinical stages in the fabrication of a definitive acrylic hollow box obturator to restore a hard palate defect. The first two papers described the restorative/surgical planning phase and the principles of obturator design.
Advances in microvascular surgery and the use of free flaps have allowed many oncology patients (with palatal tumours) to undergo resection and immediate reconstruction. Ideally, a flap with vascularized bone should be used as this will optimize the future prosthetic bearing area. If it is not possible to close the resection site surgically, the provision of an obturator is obligatory. Significant improvement in the quality of life is achieved after constructing the prosthesis, as it restores the partition between the nasal and the oral cavities, improves mastication, swallowing, speech, dental aesthetics and facial support.1
Conventional rehabilitation with an obturator may be a treatment requirement for some oncology patients post-surgical resection.2,3 For patients who will have a significant maxillary defect or are due to have radiotherapy post resection, the placement of zygomatic or dental implants at the time of ablative surgery may be advantageous to help retain the future prosthesis. However, this will require careful planning and a high degree of surgical skill. This third article in our series will discuss the clinical stages involved in making a definitive, acrylic resin, one-part hollow box obturator to restore a hard palate defect. The authors hope that it will be useful for clinicians who are new to the subject and are making their first obturators.
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