Abstract
Abstract The aim of this study was to evaluate the accuracy of two different impression techniques through the assessment of the performance of the two definitive obturators fabricated by each technique. A total of six partially edentulous patients with unilateral maxillary surgical defects were selected from those admitted at the Prosthodontic Department, Faculty of Dentistry, Alexandria University. For every patient, two hollow bulb obturators were constructed, each using a different impression technique. Three patients started with the open face tray impression technique and the other three started with the altered cast impression technique. Each patient was given one obturator at a time and was instructed to use it for 2 months. All patients were subjected to the following: (a) a preprosthetic evaluation, (b) an evaluation 2 months after the insertion of the first obturator, and (c) an evaluation 2 months after the insertion of the second obturator. During each session, speech and swallowing were evaluated. Regarding the three formant frequencies of the vowel /a/, there was a statistically significant improvement only in F1 between the altered cast and the preprosthetic phase and between the altered cast and the open face impression techniques, whereas concerning vowel /e/, there was a statistically significant improvement in F2 in favor of the altered cast impression technique. The degree of nasality in the vowels and the plosives were significantly improved in the altered cast technique. However, there was no significant improvement in the nasality between the two techniques with regard to oral and nasal sentences. There was an observed improvement in the competence and the shape of the velopharyngeal valve with the obturator than without the obturator. The altered cast technique caused statistical improvement in the nasality of vowels and plosives as compared with the open face impression technique. Both treatment modalities caused general improvement in the patient’s satisfaction and in swallowing with no statistically significant difference between them.
Highlights
Maxillectomy is a treatment option for maxillary cancer
Speech tests were conducted for each patient using the Computerized Speech Lab (CSL), a nasometer, the speech intelligibility test, and an Arabic articulation test
There was a significant increase in the F2 between the altered cast impression technique and the open face impression technique (P3 = 0.047; P ≤ 0.05)
Summary
Maxillectomy is a treatment option for maxillary cancer. This very often leaves an oronasal and/or an oroantral defect, resulting in severe functional problems concerning mastication, deglutition, and speech, and of equal importance produces a feeling of social insecurity with unfavorable psychological and economic consequences [1]. Microvascular tissue transfer is regarded as a safe and adequate treatment option, there are certain indications to use prosthetic devices for maxillectomy reconstruction. The primary goal of prosthetic obturation is the closure of the maxillectomy defect and separation of the oral cavity from the sinocaval cavities. A successful prosthetic design for functional restoration of the maxillectomy defect utilizes the remaining palate and dentition to maximize the support, the stability, and the retention of an obturator bulb.
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