• Title/Summary/Keyword: 구개 폐쇄장치

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Palatal obturator restoration of a cleft palate patient with velopharyngeal insufficiency: a clinical report (구개인두 기능부전을 갖는 구개열 환자에서 폐쇄장치를 이용한 보철 치료 증례)

  • Heo, Yu-Ri;Kim, Jong-Wook;Lee, Gyeong-Je;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.353-360
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    • 2013
  • Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

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;Jo, Kwang-Hun;Lee, Kyu-Bok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.337-342
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    • 2011
  • 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.

Patients' satisfaction on the obturators with different extension heights into defects after maxillectomy (높이가 다른 폐쇄장치에 대한 상악절제술 환자의 만족도)

  • Kwon, Ho-Beom;Lee, Jai-Bong;Yim, Soon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.41-47
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    • 2010
  • Purpose: The purpose of this study was to compare the functional abilities of the low bulb obturators with those of high bulb obturators in terms of patients' evaluation. Material and methods: This study included 11 maxillectomy patients who underwent postoperative prosthodontic rehabilitations. Two obturators of the same design except for different bulb heights, were fabricated for each of the maxillectomy patient. After two months of alternate use, the functions of the obturators were measured by investigating the patients' subjective evaluations in terms of convenience, speech, nasality, leakage, and mastication and identifying their preferred prostheses. Wilcoxon signed rank test was used as a statistical method (P < .05). Results: There were no significant differences in patient evaluations of low and high bulb obturators (P >.05). And patients' preferences varied. Conclusion: In extreme situation such as in mouth opening limitation, the use of low bulb obturators can be recommended and result in comparable speech function to that of obturators with high lateral walls.

A three-dimensional finite element analysis of obturator prosthesis for edentulous maxilla (무치악 구개결손 환자를 위한 폐쇄장치의 삼차원 유한요소 분석)

  • Song, Woo-Seok;Kim, Myung-Joo;Lim, Young-Jun;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.222-228
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    • 2011
  • Purpose: The purposes of this study were to evaluate the stress distributions and the displacements of obturator for edentulous maxillectomy patients and to compare them with those of complete denture using three-dimensional finite element analysis. Materials and methods: Based on the CT image of edentulous patient, three-dimensional finite element model of edentulous maxillae was constructed. Three-dimensional finite element model of edentulous maxillae with palatal defect was also fabricated. On each model, complete denture and obturator prosthesis were created. Vertical static force of 200 N was applied on the left maxillary premolar and molar region. The von Mises stress values and the displacements of models were analyzed using three-dimensional finite element analysis. Results: Maximum von Mises stress values were recorded in the cortical bones of both models. The von Mises stress value in the complete denture model was 2.73 MPa and 2.69 MPa in the obturator model. High von Mises stress values were also observed on the tissue surface of prosthesis. The maximum value of the displacement in the obturator was higher than that of complete denture. Conclusion: The obturator showed a worse result in terms of stress distribution and displacement than complete denture. In the prosthodontic rehabilitation of edentulous maxillectomy patient accurate impression procedure based on patients'anatomy and application of prosthodontic principle should be considered.

Prosthetic rehabilitation by double-processing technique for edentulous patient with soft palate defect after maxillectomy: A case report (연구개를 포함한 상악골 절제술을 받은 완전 무치악 환자에서 이중 온성법으로 제작한 구개 폐색장치를 통한 보철수복: 증례 보고)

  • Park, Jin-Yong;Wang, Yuan-Kun;Song, Kwang-Yeob;Park, Ju-Mi;Lee, Jung-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.356-363
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    • 2019
  • A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.