• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.4
• /
• pp.329-336
• /
• 2009

In the case of congenital malformation, acquired trauma, or maxillectomy by neoplasm, the defect in maxilla is combined with nasal cavity, maxillary sinus and oral cavity. This results in abnormal function in pronunciation, mastication, and swallowing. In this situation, the purposes of prosthodontics are also applied. The purposes of obturator for acquired maxillary deficiency patients are restoring pronunciation, mastication, and swallowing, and make patients comfortable and esthetic satisfaction. Reducing weight of the obturator makes edentulous ridge heathy and functional. It also improves patients' comfort. Hollow obturator also reduces unnecessary stress because improves physiologic function, as it weights less than 6.55-33.06% compare to usual one. This case presents the double-processing method for maxillary obturator in the patient treated hemi-maxillectomy due to malignancy neoplasm. We report this case because the patient acquired functional and esthetic satisfaction from double-processing obturator.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.2
• /
• pp.352-360
• /
• 1997

It has been reported that There is a relatively high incidence of congenital cleft lip and palate among congenital anomalies. Children with the cleft lip and palate confront various problems ranging from feeding difficulties as infants to frequent ear infections, compromised speech, aberrant dentofacial development, malocclusion and esthetic impairment with its unfavorable effects on the psychosocial adaptation of the individual. Management of these patients is a process that starts in infancy and continues on into adulthood. Through a team approach, professionals from various fields convene to assess the needs of the child and to assist the parents in dealing with the situation. A pediatric dentist, one of the team, must advise the parents the way of feeding or make an obturator for normal feeding and weight gain of infants with cleft lip and/or palate. An obturator can aid nursing, stimulate orofacial development, help develop the palatal shelves, prevent tongue distortions, prevent nasal septum irritation, decrease chance of ear infections, expand collaped maxillary segments, constrict the expanded anterior part of the maxilla, reposition the premaxilla, and help the parents psychologically. Three cases of infants with cleft lip and palate were managed with the obturator at the Dept. of Pediatric Dentistry, Kyung Hee University. In all cases, infants showed normal feeding and weight gaining after the insertion of the obturator.

• The Journal of Korean Academy of Prosthodontics
• /
• v.49 no.3
• /
• pp.222-228
• /
• 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.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.4
• /
• pp.669-676
• /
• 1999

The dentigerous cysts originate through alteration of the reduced enamel epithelium after amelogenesis is completed, with accumulation of fluid between the layers of the enamel epithelium, or between this epithelium and the tooth crown. Next to the radicular cyst, they are the second most common type of odontogenic cyst. They occur over a wide age range with a peak frequency in the 2nd to 3rd decade. A substantial majority involve the mandibular third molars, followed in order of frequency by the maxillary permanent canines, mandibular second premolars, and maxillary third molars. With regard to the treatment of these cysts, the marsupialization procedure with obturator is recommended during the age when the eruptive force of the teeth is still strong. It can be effective when preservation of the displaced teeth is desirable. We treated the dentigerous cyst by marsupialization with obturator and guided the eruption of involved teeth to normal position. And we got the results as follows : 1. Severely dislocated teeth associated with dentigerous cyst erupted into proper position. 2. The enamel hypoplasia and the root deformity were observed some cases. 3. The bone expansion and defect were healed without infection and recurrence.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.1
• /
• pp.35-40
• /
• 2016

The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.356-363
• /
• 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.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.3
• /
• pp.219-223
• /
• 2016

PURPOSE. This study aimed to create a digitized database of fabricated obturators to be kept for patients' potential emergency needs. MATERIALS AND METHODS. A chairside intraoral scanner was used to scan the surfaces of an acrylic resin obturator. The scanned data was recorded and saved as a single standard tessellation language file using a three-dimensional modeling software. A simulated obturator model was manufactured using fused deposition modeling technique in a three-dimensional printer. RESULTS. The entire obturator was successfully scanned regardless of its structural complexity, modeled as three-dimensional data, and stored in the digital system of our clinic at a relatively small size (19.6 MB). A simulated obturator model was then accurately manufactured from these data. CONCLUSION. This study provides a proof-of-concept for the use of digital technology to create a digitized database of obturators for edentulous maxillectomy patients.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.5
• /
• pp.411-416
• /
• 2016

Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.3
• /
• pp.337-342
• /
• 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.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.32 no.4
• /
• pp.322-329
• /
• 2016

Reconstruction of the maxillectomy with an obturator is to restore masticatory, swallowing, phonetic and esthetic problems. Stress created by lateral forces is minimized by the proper selection of an occlusal scheme, elimination of premature occlusal contacts, and wide distribution of supporting area. It should be considered that properly designed retainers reduce the stresses transmitted to the abutment while the obturator is in function. The following clinical report presents palatal obturator treatment with implant assisted removable partial denture (IARPD) design that restores normal function and esthetics in patients who experienced maxillectomy and dental implant failure.