Fabrication of a movable obturator following maxillary reconstruction with slit-shaped fenestration.

Related Articles

Fabrication of a movable obturator following maxillary reconstruction with slit-shaped fenestration.

J Prosthodont. 2015 Apr;24(3):254-9

Authors: Murakami M, Nishi Y, Umezono M, Kamashita Y, Nishimura M

Abstract
Extensive maxillary resection has generally been reconstructed with free skin flaps. Because drooping of the transferred flap causes instability of the obturator prosthesis, maxillary reconstruction often incorporates a slit-shaped oronasal fenestration. Although obturator prostheses for edentulous patients are stabilized with the help of oronasal slits, those for dentate patients are unstable because of flap mobility, resulting in a harmful lateral force exerted on the abutment teeth, causing dislodging of the denture. This report evaluates the benefits of a movable obturator prosthesis for a 60-year-old dentulous patient with maxillary sinus carcinoma. The patient underwent left-sided total maxillectomy, and the defect was reconstructed with a slit-shaped fenestration using a rectus abdominis flap. A conventional obturator prosthesis was inserted; however, drooping of the flap caused instability of the obturator, resulting in nasal regurgitation and fracture of the clasp. To solve this problem, we designed an obturator prosthesis with a movable connection consisting of a ball attachment (patrix) in the metal base and a socket (matrix) in the obturator, which acted as a stress breaker against the harmful force exerted by the flap. Application of this movable obturator prosthesis was a useful solution for a compromising situation created by the surgical procedure. No clinical disorders were observed at the 3-year follow-up.

PMID: 25092072 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2vM7V8W