Two-piece Obturator Research Articles

Hollowing of Obturators for Post-Mucormycosis Maxillary Defects: Technique Based Case Series

Post COVID-19 extensive use of steroids led to mucormycosis induced invasive sinusitis in many patients. Location and extent of the fungal infection decides the amount of maxillectomy to be performed. Post surgical rehabilitation with an obturator is required to restore function of mastication deglutition and speech. Large size of the defect and missing teeth on defect side compromise the retention of obturator and at the same time make them heavy and uncomfortable. This case series describes prosthodontic management of four casestwo partially and two completely edentulous patients operated for mucormycosis with healed palatal defects unilaterally with chief complains of inability to speak and eat. All the defects were treated with a hollow maxillary obturator prosthesis fabricated using different designs and hollowing techniques. All the patients were treated with single piece definitive hollow obturator prosthesis using different fabrication techniques aimed at reducing the weight and thus enhancing patient comfort and function. A single-piece obturator prostheses reduce the chances of plaque or bacterial accumulation to a minimal amount. This helps in maintenance of better hygiene by the patient as compared to a two-piece obturator prosthesis.

Finite element stress analysis of Aramany class I maxillectomy defect with single- and two-piece closed bulb obturators.

To evaluate the stress on the surrounding structures of Aramany class I maxillectomy defect restored with different obturator prostheses. Definitive three-dimensional (3D) finite element (FE) model of Aramany class I defect rehabilitated with single- and two-piece closed bulb obturator prostheses was constructed based on patient computed tomography (CT) using a software. Unilateral defect restored with tripodal design single-piece closed bulb obturator was used as FE model 1- and two-piece magnet retained closed bulb obturators as FE model 2. Finite element analysis (FEA) with three different load (150N, 200N and 250N) applications was used to calculate the equivalent von Mises stress. A least stress value of 62.28MPa was observed in two-piece closed bulb design with 150N force, and highest stress value of 104.15MPa was observed in single-piece obturator with application of 250N force. Minor difference in stress distribution pattern was observed between single-piece obturator and two-piece obturator, and stress value was comparatively lesser in two-piece than single-piece obturator. The stress pattern, distribution and numerical values increased with increase in magnitude of forces. More stress was observed on the lateral slopes of obturator closer to defect than in other areas of the obturator.

Rehabilitation of a partial maxillary defect with magnet retained two-piece hollow bulb obturator

A restricted mouth opening in hemimaxillectomy patients can create a significant problem with insertion and removal of the obturator prosthesis. A two-piece obturator is an alternative management for such patients. The treatment of a patient with a hemimaxillectomy due to squamous cell carcinoma is presented in this clinical report. A sectional obturator prosthesis retained by magnets was fabricated to deal with trismus, fibrosis, and microstomia. The patient's esthetic and functional expectations were satisfied. The new generation of magnets with improved technology provides sufficient denture retention for clinical application. However, further follow-up may be necessary to ascertain the long-term usefulness of the magnet-retained obturator prosthesis, because of corrosion and further loss of magnetism.

A Direct Investment Method of Closed Two-Piece Hollow Bulb Obturator

Maxillary defects occur due to surgical treatment of benign and malignant tumors, congenital malformation, and trauma. Prosthetic rehabilitation in such patients is influenced by the size and location of the defect. The most common of all intraoral defects are seen in the maxilla, in the form of an opening into the maxillary sinus and nasopharynx. These defects create disabilities in speech, deglutition, and mastication. The prosthesis which closes such an opening and recreates the functional separation of the oral cavity and sinus and nasal cavities is referred to as an obturator. Numerous techniques of hollow bulb fabrication have been mentioned in the literature from time to time. But there are only a few methods for bulb fabrication in two-piece obturator. This technique describes a direct investment method of waxed-up closed hollow bulb two-piece obturator.

Subway Mandibular Buccal Defect Blocked with Two Part Prosthesis Unified by Earth Magnets

This clinical report describes the fabrication of a two-piece obturator used to close the mandibular buccal defect. Two-piece obturator prosthesis was fabricated with clear heat cure acrylic resin to be used during the healing period following the marsupialization of odontogenic keratocyst which had lead to the loss of portions of the mandibular buccal region. The prosthesis fabricated in two parts was joined by the rare earth magnets. Retention was increased by lining the prosthesis with tissue conditioner material engaging the undercut.