Flexible intraoral stents

Abstract

n tiring and following head and neck surgery, surgeons may require intraand/or extraoral stents and obturators that are used (1) for grafts, (2) for repositioning tissues, (3) as medication carriers, (4) as dressings, and (5) for immediate obturation of defects created by the surgical eradication of malignancies.i-5 The proper fabrication of such prostheses is usually done from presurgical casts with the assistance of the surgeon. The design is made from a drawing on the cast and is an approximation of the anticipated extent, amount, and area of structure to be removed and/or the region requiring coverage. Often during surgery the prefabricated prostheses may require modifications to correct underor overextensions of the borders. Most surgeons are not trained to modify prostheses in the operating room and usually require the assistance of a maxillofacial prosthodontist and/or technician as well as special laboratory equipment. These added personnel increase the costs of the surgical procedure (personnel and operating room time). The proposed surgical stent and/or obturator can be modified easily and quickly by the surgeon with standard operating room equipment such as a scalpel, scissors, rasp, and marking pencil. The requirements of the prosthesis are that (1) it should be constructed of materials that are tissue tolerated, nonporous, easily sterilized, and easily relined postsurgically; (2) it must be easy, not time consuming, and inexpensive to make; (3) it should not distort easily and should be relatively flexible; (4) it should be overextended beyond the anticipated borders, and the overextensions should be readily adjusted; and (5) the corrected borders must be smooth and not cause pressure irritation. This article describes an alternative approach to the intraoral surgical maxillary obturator prosthesis by means of various designs and materials.