International Journal of Prosthetic Dentistry2011:2(1) 22-26 ISSN 2231-2269 Available at http://www.journalgateway.com ©2011 International Journal of Prosthetic Dentistry. Published by Publishing Division, Celesta Software Private Limited. All Rights Reserved CASE REPORT Definitive Maxillary Obturator Prostheses Naveen YG, Rajesh Sethuraman, Paranjay Prajapati Abstract Goal of prosthodontics is rehabilitation of missing oral and extra oral structures with restoration of normal function of mastication, speech, swallowing, appearance etc. Malignancies are common in oral region, which are treated through surgical intervention. Surgical intervention creates anatomic defect which forms communication among the oral cavity, nasal cavity and maxillary sinus. In such cases it is very difficult for the patient to perform various normal functions like mastication, swallowing, and speaking etc. Prosthodontic rehabilitation with obturator prosthesis restores the missing structures and act as a barrier between the communications among the various cavities. Keywords: Obturator, Oro antral communication Introduction Ablative surgical therapy is frequently adopted for the control of malignancies and other abnormal growths within the maxillary sinuses. This creates an anatomic defect that allows the oral cavity, maxillary sinus and nasal cavity to become one compartment(1). Prosthetic rehabilitation with obturator prosthesis is a predictable intervention to recreate an anatomic barrier between the cavities and to restore functional capabilities of speech, oral food intake and deglutition(2). Rehabilitation of the maxillectomy defect has been well defined for prosthodontists and surgeons (3-7). All prosthodontists are aware of the basic objectives of prosthodontic therapy. The degree of extension into the defect varies depending upon the configuration of the defect, character of its lining tissue, and functional requirements for retention, support, and stabilization of the prosthesis(3). In large defects lacking palatal support, the obturator is aggressively extended vertically to engage the surgical defect and horizontally to the lateral aspect of the orbital floor, at the expense of its size and weight. Remaining structures are subjected to continuous stresses from such large, heavy obturator, jeopardizing the health of the tissues, and compromising patient function and comfort(4,5). To reduce the weight of the prosthesis, the bulb portion of the obturator is generally hollowed after it has been processed into acrylic resin. Weight reduction is especially important when the obturator prosthesis is suspended without bony or posterior tooth support on the defect side, as is the case with most maxillary resection prostheses(6). A hollow maxillary obturator may reduce the weight of the prosthesis by up to 33%, depending upon the size of the maxillary defect(7). Case report: A 52-year-old male patient reported to the prosthodontic department of K.M.Shah Dental College and Hospital, Vadodara, Gujarat, for replacement of his existing obturator. The patient’s medical history revealed that he had under gone a surgical intervention with left sided modified neck dissection sparing IJV and spinal accessory nerve with left sided hemi mandibulectomy sparing the condyle and left sided maxillectomy due to squamous cell carcinoma affecting that particular region. Later, the defect was obturated with the help of an interim obturator. The intra-oral examination revealed a total maxillectomy of the left side. The presented defect situation corresponded to a Class I situation (resection performed along the palatal