Acquired maxillectomy defects produce hypernasal speech, food, and liquid regurgitation into the nasal cavity, impaired deglutition and mastication, and cosmetic deformity. Furthermore, patients with acquired maxillary defects face psychosocial stigma, which has a negative impact on their quality of life. Prosthetic rehabilitation of such defects is required for stomatognathic system restoration and oroantral communication obturation. This case series discusses the fabrication of surgical, interim, and definitive obturator prostheses to restore the acquired dentate maxillectomy defects of three cancer patients. All patients had their treatment in the prosthodontics department of the RUHS College of Dental Sciences. The surgical obturator prosthesis was made before surgery, whereas the interim and definitive obturators were made one month and six months after surgery, respectively. The surgical obturator formed a shield between the surgical pack and the oral cavity. After the surgical obturator and packing were removed, an interim obturator was inserted for three to six months to allow the surgical site to heal. After the surgical site had healed, the fabrication of the definitive obturator began. Prosthetic rehabilitation with obturator prostheses sealed the acquired tissue defects of the palate and restored swallowing, speaking, chewing capacity, and cosmetic value, as well as significantly improved the quality of life of these patients.
Patients with minor defects of the alveolar ridge and hard palate can easily be treated by surgical closure, while patients with larger defects are more amenable to prosthetic restoration. The case report describes the rehabilitation of a dentate maxillectomy patient with a definitive closed hollow bulb cast partial obturator. A tripod retainer design was chosen for direct retention in the case. The tripod design consisted of a T-bar clasp placed on the left first central incisor and two embrasure clasps with buccal retention and palatal bracing components between the right first & second premolar and right first & second molar. A complete palate major connector was designed to ensure uniform distribution of functional load across tissues. The remaining teeth, the palate, and the rest provided support for the prosthesis. Prosthetic rehabilitation of the defect with a definitive obturator thus seals tissue openings in the palate, improves deglutition, speech, mastication, aesthetics, and significantly improves quality of life.