• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.167-171
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• 2016

Patients undergone partial maxillectomy experience post-operative masticatory, phonetic, and swallowing difficulties. They also encounter social and psychological challenges due to changes in their facial appearances. Thus, functional and esthetic recovery through maxillofacial prosthesis becomes significant for these patients. The objective of an appropriate obturator is to restore palate and improve phonetic and swallowing ability by separating the oral cavity, nasal cavity, maxillary sinus, and nasopharynx. In this case report, an obturator was fabricated for a patient who had partial resection from the maxillary posterior region to the pharynx due to squamous cell carcinoma. The purpose of this case study is to describe the results because the patient was successfully improved both functionally and esthetically.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.33-38
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• 2010

Maxillectomy is a treatment option for maxillary cancer, which leaves the patient with a palatal defect. It may cause problems with facial deformation, swallowing, mastication, and speech. These functional problems and changes in appearance may result in psychological problems. To control these deficits after maxillectomy, surgical reconstruction or prosthodontic treatment can be chosen as a treatment option. Obturator prosthesis has been used as a preferred method of rehabilitation for most maxillectomy patients. This case is a patient who was classified Aramany classification II hemi-maxillectomy patient with residual teeth from #11-25, whose teeth had substantial labioversion and clinically lengthened from alveolar bone involution, thus making it hard to select proper framework design and resist to the rotational dislodging force of the obturator. Therefore we selected swing-lock attachment design to remain pre-existing crown and bridges and obtain retention and stability of obturator. The swing-lock RPD is economical than the conventional RPD because we can remain pre-existing crown and bridges. And residual teeth which have mobility and poor prognosis can be successfully retained through properly designed swing-lock RPD as it is functioning as a removable splint on the teeth.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.319-324
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• 2017

Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.331-337
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• 2018

Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.281-293
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• 2021

Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.229-236
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• 2023

Maxillary bone defects may follow surgical treatment of benign and malignant tumors, trauma, and infection. Palatal defects often lead to problems with swallowing and pronunciation from the leakage of air into the nasal cavity and sinus. Obturators have been commonly used to solve these problems, but long-term use of the device may cause irritation of the oral mucosa or damage to the abutment teeth. Utilizing implants in the edentulous area for the fabrication of the obturators has gained attention. This case report describes a patient, who had undergone partial resection of the maxilla due to adenocarcinoma, in need of a new obturator after losing abutment teeth after long-term use of the previous obturator. Implants were placed in strategic locations, and an implant-retained maxillary obturator was fabricated, showing satisfactory results in the rehabilitation of multiple aspects, including palatal defect, masticatory function, swallowing, pronunciation, and aesthetics.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.259-262
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• 2006

Fibrous dysplasia(FD) of the bone is a slowly progressive, benign disease of unknown cause where normal architectures are replaced with fibrous and osteoid tissue. FD of the maxilla usually manifests as a bony enlargement with painless swelling and bone deformity, contouring to facial asymmetry. The lesion may involve the nasal fossae, orbits, or alveolus bone, causing diverse functional disturbance. Treatment options range from shaving to total maxillectomy and reconstruction depending on the presenting symptoms. Shaving, partial maxillectomy and maxillary sinus formation was performed in 5 patients with fibrous dysplasia in the past 2 years. Follow up period ranged from 1 month to 11 months. Aesthetic appearance, CT findings, and relief from symptoms were compared. In all patients, facial asymmetry was restored to symmetry and nasal obstructive symptoms were improved. With this procedure, expansion of the lesion will be controlled until puberty, preventing the development of new functional disturbances. After puberty, no further treatment can be anticipated due to the growth arrest inherent to the disease.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.479-484
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• 2007

A case of epithelial-myoepithelial carcinoma transformed in pleomorphic adenoma occurring in palate of a 61 years old woman is reported. The tum or was composed of 2 different components, pleomorphic adenoma and epithelial myoepithelial carcinoma, accounting for approximately 40% and 60% of whole tumor, respectively. As the results of the immunohistopathologic study, epithelial-myoepithelial carcinoma showed multiple tubular or solid nest, which were separated by a basement membrane and considered of variable proportion of 2 cell types, cuboidal epithelial cells positive for cytokeratin and clear myoepithelial cells positive for glial fibrillary acid protein, wheres the myoepithelial nest of pleomorphic adenoma intermingled with hyaline and myxoid stroma. The malignancy was demonstrated by convincing evidence of invasion into the submucosa, although the epithelial-myoepithelial carcinoma component was mostly surrounded by the pleomorphic adenoma componemts. An increased immunoreactivity of proliferating cell nuclear antign in the epithelial myoepithelial carcinoma area in comparison to the pleomorphic adenoma also suggested epithelial-myoepithelial carcinoma arising in a pleomorphic adenoma.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.29-39
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• 1989

Ossifying fibroma is a relatively slow growing tumor, and likely to have presented for some years before its clinical diognosis. The usually well circumscribed nature of ossifying fibroma in jaws lends itself to relative ease of excision and hence the favorable therapeutic results. On occasion, however, particulary in juvenile patient, if maxilla the tumor assumes an aggressive behavior. In that case, because the tumor grows invasively, resection with a margin of healthy tissue is indicated. The case presented is 34 - year old female. The patient had noticed a gradual swelling of the right side of the face approximately 2 months in duration correlation with a intermittent pain on the right maxillary molar area. Palpation disclosed firm swelling on the right anterior and lateral walls of the maxillary sinus extended to the maxillary tuberosity area. The radiographic examination revealed soft tissue mass with multiple dense round calcifications with destruction of anterior and posterolateral wall of the right maxillary sinus and right alveolar process, and hard palate. The mass totally obliterated maxillary sinus and extended to the pterygopalatine fossa. The histologic diagnosis from the biopsied specimen revealed ossifying fibroma. The tumor mass was resected by subtotal maxillectomy procedure due to a recent rapid infiltrative growth. In 5 months of postoperative follow - up period, the patient has favorable prognosis.