Severe Maxillectomy Defect Rehabilitation with an Implant-Retained Obturator Prosthesis: A Case Report
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Abstract
Conventional obturator prostheses might cause dissatisfaction in patients with hard or soft palate defects due to inadequate retention and function during speech, mastication, and swallowing. Thus, surgical reconstruction and implant-supported obturators are considered as alternative treatments for these patients.
This case-report study describes the prosthetic reconstruction of an 88-year-old patient suffering from a hard palate defect after surgical resection of verrucous carcinoma in the left side of the hard palate. Fifteen months after radiotherapy, two implants were placed in the right side of the remaining ridge, in the second and third molar region. After the implant healing period, the implant-supported obturator prosthesis was fabricated. The patient was satisfied with the esthetics and function of the obturator at the 12-month recall visit and radiographs showed normal healing and no bone loss around the implants.
1. Boyes-Varley JG, Howes DG, Davidge-Pitts KD, Brånemark I, McAlpine JA. A protocol for maxillary reconstruction following oncology resection using zygomatic implants. Int J Prosthodont. 2007 Sep-Oct;20(5):521-31.
2. Lundgren S, Moy PK, Beumer J 3rd, Lewis S. Surgical considerations for endosseous implants in the craniofacial region: a 3-year report. Int J Oral Maxillofac Surg. 1993 Oct;22(5):272-7.
3. Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW, et al. Quality of life of maxillectomy patients using an obturator prosthesis. Head Neck. 1996 Jul-Aug;18(4):323-34.
4. Abu-Serriah MM, McGowan DA, Moos KF, Bagg J. Outcome of extra-oral craniofacial endosseous implants. Br J Oral Maxillofac Surg. 2001 Aug;39(4):269-75.
5. Fukuda M, Takahashi T, Nagai H, Iino M. Implant-supported edentulous maxillary obturators with milled bar attachments after maxillectomy. J Oral Maxillofac Surg. 2004 Jul;62(7):799-805.
6. Parr GR, Gardner LK. The evolution of the obturator framework design. J Prosthet Dent. 2003 Jun;89(6):608-10.
7. Fujimoto T, Niimi A, Ueda M. Implant-supported prostheses after maxillary cancer resection: preliminary report. Implant Dent. 1997 Winter;6(4):295-8.
8. Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991 Apr-Jun;2(2):81-90.
9. Markt JC. An endosseous, implant-retained obturator for the rehabilitation of a recurrent central giant cell granuloma: a clinical report. J Prosthet Dent. 2001 Feb;85(2):116-20.
10. Schmidt BL, Pogrel MA, Young CW, Sharma A. Reconstruction of extensive maxillary defects using zygomaticus implants. J Oral Maxillofac Surg. 2004 Sep;62(9 Suppl 2):82-9.
11. Roumanas ED, Nishimura RD, Davis BK, Beumer J 3rd. Clinical evaluation of implants retaining edentulous maxillary obturator prostheses. J Prosthet Dent. 1997 Feb;77(2):184-90.
12. Alhaji MN, Ismail IA, Khalifa N. Maxillary obturator prosthesis for a hemimaxillectomy patient: a clinical case report. Saudi J Dent Res. 2016;7:153‐159.
13. Wang N, Huang M, Lv H. Head and neck verrucous carcinoma: A population-based analysis of incidence, treatment, and prognosis. Medicine. 2020 Jan; 99: e18660.
14. Marur S, Forastiere AA. Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2016 Mar;91(3):386-96.
15. Irish J, Sandhu N, Simpson C, Wood R, Gilbert R, Gullane P, et al. Quality of life in patients with maxillectomy prostheses. Head Neck. 2009 Jun;31(6):813-21.
16. Rieger JM, Wolfaardt JF, Jha N, Seikaly H. Maxillary obturators: the relationship between patient satisfaction and speech outcome. Head Neck. 2003 Nov;25(11):895-903.
17. Beumer J, Curtis TA, Firtell DN. Maxillofacial Rehabilitation. Prosthodontic and Surgical Considerations. St. Louis, Toronto: C.V. Mosby Co; 1979.
18. Brown KE. Clinical considerations improving obturator treatment. J Prosthet Dent. 1970 Oct;24(4):461-6.
19. Leles CR, Leles JL, de Paula Souza C, Martins RR, Mendonça EF. Implant-supported obturator overdenture for extensive maxillary resection patient: a clinical report. J Prosthodont. 2010 Apr;19(3):240-4.
20. Brånemark PI, Gröndahl K, Ohrnell LO, Nilsson P, Petruson B, Svensson B, Engstrand P, Nannmark U. Zygoma fixture in the management of advanced atrophy of the maxilla: technique and long-term results. Scand J Plast Reconstr Surg Hand Surg. 2004;38(2):70-85.
21. Weischer T, Schettler D, Mohr C. Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants. 1997 Mar-Apr;12(2):211-4.
22. Alqutaibi AY. Alqutaibi AY. Enhancing retention of maxillary obturators using dental implants. Int. J. Contemp. Dent. Med. Rev. 2015;2:010915.
23. Amer MM, Rashad HA, Abdallah S. Stress distribution of implant retained obturators using different types of attachments: A three dimensional finite element analysis. Tanta Den J. 2015 Dec 1;12:S30-40.
24. Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: classification. J Prosthet Dent. 1978 Nov;40(5):554-7.
25. Keyf F. Obturator prostheses for hemimaxillectomy patients. J Oral Rehabil. 2001 Sep;28(9):821-9.
2. Lundgren S, Moy PK, Beumer J 3rd, Lewis S. Surgical considerations for endosseous implants in the craniofacial region: a 3-year report. Int J Oral Maxillofac Surg. 1993 Oct;22(5):272-7.
3. Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW, et al. Quality of life of maxillectomy patients using an obturator prosthesis. Head Neck. 1996 Jul-Aug;18(4):323-34.
4. Abu-Serriah MM, McGowan DA, Moos KF, Bagg J. Outcome of extra-oral craniofacial endosseous implants. Br J Oral Maxillofac Surg. 2001 Aug;39(4):269-75.
5. Fukuda M, Takahashi T, Nagai H, Iino M. Implant-supported edentulous maxillary obturators with milled bar attachments after maxillectomy. J Oral Maxillofac Surg. 2004 Jul;62(7):799-805.
6. Parr GR, Gardner LK. The evolution of the obturator framework design. J Prosthet Dent. 2003 Jun;89(6):608-10.
7. Fujimoto T, Niimi A, Ueda M. Implant-supported prostheses after maxillary cancer resection: preliminary report. Implant Dent. 1997 Winter;6(4):295-8.
8. Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991 Apr-Jun;2(2):81-90.
9. Markt JC. An endosseous, implant-retained obturator for the rehabilitation of a recurrent central giant cell granuloma: a clinical report. J Prosthet Dent. 2001 Feb;85(2):116-20.
10. Schmidt BL, Pogrel MA, Young CW, Sharma A. Reconstruction of extensive maxillary defects using zygomaticus implants. J Oral Maxillofac Surg. 2004 Sep;62(9 Suppl 2):82-9.
11. Roumanas ED, Nishimura RD, Davis BK, Beumer J 3rd. Clinical evaluation of implants retaining edentulous maxillary obturator prostheses. J Prosthet Dent. 1997 Feb;77(2):184-90.
12. Alhaji MN, Ismail IA, Khalifa N. Maxillary obturator prosthesis for a hemimaxillectomy patient: a clinical case report. Saudi J Dent Res. 2016;7:153‐159.
13. Wang N, Huang M, Lv H. Head and neck verrucous carcinoma: A population-based analysis of incidence, treatment, and prognosis. Medicine. 2020 Jan; 99: e18660.
14. Marur S, Forastiere AA. Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2016 Mar;91(3):386-96.
15. Irish J, Sandhu N, Simpson C, Wood R, Gilbert R, Gullane P, et al. Quality of life in patients with maxillectomy prostheses. Head Neck. 2009 Jun;31(6):813-21.
16. Rieger JM, Wolfaardt JF, Jha N, Seikaly H. Maxillary obturators: the relationship between patient satisfaction and speech outcome. Head Neck. 2003 Nov;25(11):895-903.
17. Beumer J, Curtis TA, Firtell DN. Maxillofacial Rehabilitation. Prosthodontic and Surgical Considerations. St. Louis, Toronto: C.V. Mosby Co; 1979.
18. Brown KE. Clinical considerations improving obturator treatment. J Prosthet Dent. 1970 Oct;24(4):461-6.
19. Leles CR, Leles JL, de Paula Souza C, Martins RR, Mendonça EF. Implant-supported obturator overdenture for extensive maxillary resection patient: a clinical report. J Prosthodont. 2010 Apr;19(3):240-4.
20. Brånemark PI, Gröndahl K, Ohrnell LO, Nilsson P, Petruson B, Svensson B, Engstrand P, Nannmark U. Zygoma fixture in the management of advanced atrophy of the maxilla: technique and long-term results. Scand J Plast Reconstr Surg Hand Surg. 2004;38(2):70-85.
21. Weischer T, Schettler D, Mohr C. Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants. 1997 Mar-Apr;12(2):211-4.
22. Alqutaibi AY. Alqutaibi AY. Enhancing retention of maxillary obturators using dental implants. Int. J. Contemp. Dent. Med. Rev. 2015;2:010915.
23. Amer MM, Rashad HA, Abdallah S. Stress distribution of implant retained obturators using different types of attachments: A three dimensional finite element analysis. Tanta Den J. 2015 Dec 1;12:S30-40.
24. Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: classification. J Prosthet Dent. 1978 Nov;40(5):554-7.
25. Keyf F. Obturator prostheses for hemimaxillectomy patients. J Oral Rehabil. 2001 Sep;28(9):821-9.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/fid.v21i2.14669 | |
| Keywords | ||
| Dental Implants Palatal Obturators Surgery Oral | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Niakan S, Asgari N, Rafeie N, Barati S. Severe Maxillectomy Defect Rehabilitation with an Implant-Retained Obturator Prosthesis: A Case Report. Front Dent. 2024;21.
