Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Prosthetic Treatment with Palatal Obturator for the Patient who had Hemimaxillectomy: Case Report

상악골 부분 절제술을 받은 환자에서 구개 폐쇄 장치를 이용한 보철치료: 증례보고

  • Choi, Su-Jeong (Dept. of Prosthodontics, College of Dentistry, Kyung-Pook National University) ;
  • Jo, Kwang-Hun (Dept. of Prosthodontics, College of Dentistry, Kyung-Pook National University) ;
  • Lee, Kyu-Bok (Dept. of Prosthodontics, College of Dentistry, Kyung-Pook National University)
  • 최수정 (경북대학교병원 치과 보철과) ;
  • 조광헌 (경북대학교병원 치과 보철과) ;
  • 이규복 (경북대학교병원 치과 보철과)
  • Received : 2011.06.10
  • Accepted : 2011.09.25
  • Published : 2011.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Congenital or traumatic loss on the oral and maxillary area or the loss of jaws due to the surgical excision of a tumor causes functional problems, such as masticatory and swallowing disorders, phonetic problems and psychological disorders in patients. In most cases, a prosthetic restoration is needed to resolve these problems and restore the damaged tissue and function. When loss occurs on the maxilla, foods and liquids leak into the nasal cavity, and a nasal sound can be heard due to air leakage into the removed area. In these cases, the palatal obturator can be used to improve the esthetic and functional aspects because it restores the removed area of the maxilla and closes the opened route between the oral cavity and maxillary sinus or nasal cavity. In this case report, a palatal obturator was applied to patients who had a hemimaxillectomy due to the occurrence of squamous cell carcinoma on the right maxillary area. Therefore, fundamental functions, such as phonetic and swallowing functions were restored, and the esthetic aspects of the facial profile were improved.

악안면 부위의 선천적 결손이나 외상성 손실, 종양의 외과적 절제 등에 의한 악골의 결손은 환자에게 저작 장애, 연하 장애 등의 기능적 문제와 발음장애 및 심미적 장애를 초래하게 된다. 이러한 장애를 줄여주고 손상된 조직과 기능을 회복시켜주기 위해 많은 경우 보철적인 수복을 필요로 하게 된다. 상악골에 결손부가 생긴 경우 음식물과 액체가 비강으로 새어나가고 이 결손부로 공기가 누출되어 과비음이 발생한다. 이런 경우에 구개 폐쇄 장치가 사용되는데, 이 장치는 상악의 결손부를 채우고 구강과 상악동 또는 비강과의 개통부를 차단하여 심미성을 증진시키고 기능을 회복시킨다. 본 증례의 환자는 우측 상악동에 편평상피세포 암종이 발생하여 상악골 부분 절제술을 시행한 환자로 구개 폐쇄 장치를 제작하여 장착한 후, 발음과 연하 등의 기본적 기능이 회복되었고 안모의 심미성이 증가하였다.

Keywords

References

  1. Fattore LD, Edmonds DC. A technique for the obturation of anterior maxillary defects with accompanying mid facial loss. J Prosthet Dent 1987;58:203-205 https://doi.org/10.1016/0022-3913(87)90177-6
  2. Balbulian AH. Maxillofacial prosthetics: Evolution and practical application in patient rehabilitation. J Prosthet Dent 1965;15:554-568 https://doi.org/10.1016/S0022-3913(65)80025-7
  3. Brown KE. Fabrication of a hollow bulb obturator. J Prosthet Dent 1969;21:97-103 https://doi.org/10.1016/0022-3913(69)90035-3
  4. Chalian et al, Maxillofacial prosthetiecs multidisciplenary practice. Balimore 1972. The willian and wilkins co.
  5. El mahdy AS. Processing a hollow obturator. J Prosthet Dent 1969;22:683-686
  6. Minsley GE, Nelson DR, Rothenberger SL. An alternative method for fabrication of a closed hollow obturator. J Prosthet Dent 1986;55:485-489 https://doi.org/10.1016/0022-3913(86)90183-6
  7. Hahn GW. A comfortable silicone bulb obturator with or without denture. J Prosthet Dent 1972;28:313-317 https://doi.org/10.1016/0022-3913(72)90225-9
  8. Ohyama T, Gold HO, Pruzansky S. Maxillary obturator with silicon lined hollow extension. J Prosthet Dent 1975;34:336-341 https://doi.org/10.1016/0022-3913(75)90114-6
  9. Taicher S. et al. A technique for fabrication of polydimethyl siloxane-acrylic resin obturator. J Prosthet Dent 1983;50:65-68 https://doi.org/10.1016/0022-3913(83)90168-3
  10. Nidiffer TJ, Shipmon TH. The hollow bulb obturator for aquired palatal openings. J Prosthet Dent 1957;7:126-134 https://doi.org/10.1016/0022-3913(57)90016-1
  11. Desjardins RP. Obturator prosthesis design for acquired maxillary defects. J Prosthet Dent 1978;39:424-435 https://doi.org/10.1016/S0022-3913(78)80161-9
  12. Gay WD, King GE. Applying basic prosthodontic principles in the dentulous maxillectomy patients. J Prosthe Dent 1980;43:433-435 https://doi.org/10.1016/0022-3913(80)90216-4
  13. Martin JW, King GE. Framework retention for maxillary obturator prostheses. J Prosthet Dent 1984;51:669-672 https://doi.org/10.1016/0022-3913(84)90415-3
  14. Beumer III J, Curtis TA, Firtell DN. Maxillofacial rehabilitation. Prosthodontic and surgical considerations, pp. 188-243. The D. B. mosby co., St Louis, Toronto, London.
  15. Coffey KW. Obturation of congenital or aquired intra oral anatomic defects. J Prosthet Dent 1984;52:559-561 https://doi.org/10.1016/0022-3913(84)90346-9
  16. Oral K. Construction of a buccal flange obturator. J Prosthet Dent 1979;41:193-197 https://doi.org/10.1016/0022-3913(79)90307-X
  17. Chalian VA. Maxillofacial Prosthetics: An althernative to plastic surgery. Proceedings of the second international prosthetic congress 1979. The D.V. Mosby Co. St. Louise p.242
  18. Oral K., Aramany MA, Mc Willians BJ. Speech intelligibility with the buccal flange obturator. J Prosthet Dent 1979;41:323-328 https://doi.org/10.1016/0022-3913(79)90017-9