Palatal Obturators

8/3/2019 Palatal Obturators

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It is a maxillofacial

prosthesis used to

Close

cover

maintain the integrity of

the oral and nasalcompartments


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restore the separation between the oraland nasal cavities

enable the patient to swallow maintain or provide mastication,

sufficient occlusion and mandibularsupport

support the soft facial tissues re-establish speech

restore an aesthetically pleasing smile.


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Can be too heavy

Can be too expensive.

Debris build-up Require insertion and removal

Have to redo periodically due to growth

Can be lost or damaged

May be very uncomfortable due to itssize

Compliance is often poor


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Lack of support,retention andstability

Solution:

xPalatal adhesives

xSilicon palatal obturator


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Classification reflects the intervention

time period used in the maxillofacial

rehabilitation of the patient.


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Additional retention is

provided by:

Dentulous- claspsEdentulous- wires,sutures, bone screws


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during or immediately following surgery

frequently revised in the operating room

during surgery

To support the surgical packing placedin the resectioned cavity created by the

removal of the walls of the maxillary sinus To restore continuity of the hard palate

5-10 days


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completion of initial healing followingsurgery

Frequent revisions As the patient heals, the surgical site

becomes smaller. The material can bereduced with a carbide bur and readaptedwith the addition of more liner.

To restore deglutition and speech by

restoring palatal contours and separatingthe nasal contours, maxillary sinus, andnasopharynx from the oral cavity.

2 to 6 months


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when further tissue changes or

recurrence of tumor are unlikely

when tissue healing and contraction arecomplete.

Relined as needed

Long-term use


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Selection of Impression material:

Alginate

Impression compound

Elastomeric impression material

Parents are instructed not to feed the

infant for at least two hours prior to theprocedure.


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High volume suction must be ready, at alltimes, in case regurgitation of the stomachcontents occurs during the procedure.

Infant must be fully awake.

Impression done without any anesthesia orpremedication

Infants should be able to cry during theimpression procedure and absence ofcrying may be indicative of airwayblockage.


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The parent sits on a stool of adjustable

height. The infant is made to lie in a

supine position on the lap of the parentwith the head on the knee at a lower

level.

The clinician positions himself in a

comfortable 10 oclock position to the

infants head.


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Figure 1. Wax sheet after initial intraoraladaptation in BCLP infant


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A stone model of the negative waxreproduction is then obtained

Stone cast used to fabricate the acrylic tray


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A wax spacer is adapted on the stone model on

which a custom acrylic tray with a handle isprepared

The tray is smoothened and polished to avoid

rough areas.

Custom acrylic tray smoothened and polished


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Final Impression of the BCLP

infant made with infantlying on the lap of the parent


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Final Impression of BCLP

infant in fastsetting putty material


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A 62-year-old female suffering from

squamous carcinoma involving the left

hard palate, the left inferior nasal fossawith the initial invasion of the floor of the

left maxillary sinus


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Intra-oral view between oral cavity andleft nasal fossa following left anteriormaxillectomy.


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Completed hollow obturator prosthesis,initially used by the patient, latersubstituted with a self-stabilizing prosthesis.


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Silicon layer, on resin structurewith part with dentures.

S

ilicon-typeprosthesis


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A 77-year-old male with squamous cell

Underwent an inferior-lateral

maxillectomy and functional dissectionof the right lateral-cervical lymph node(of the nasal fossa, the third anterior-

inferior of the nasal septum and thecolumella.


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Intra-oral view ofthe lateral post-maxillectomy

defect.

Hollow palatalobturator with

dentures.


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Intra-oral view ofthe posterior post-

maxillectomy

defect.

Side view of palatal

obturator which haspartial dentures.


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37 year old woman with cerebral palsy

and a cleft lip and palate

treated surgically but still has an oronasalfistula.


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The objective here was to seal the

oronasal communication and stabilize

the margins of the defect by inserting atemporary obturator, as well as

replacing the missing teeth with

provisional, partial and removable resin

prostheses.


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48 year old female

consumption of alcohol intake since the

age of 20 marijuana consumption for 10 years

cocaine usage for 1 year with 1 gr.

consumption per day Final diagnosis chronic ulcer due to

cocaine intranasal exposure.


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Documents

Palatal Obturators