MAXILLARY OBTURATOR

Supervised by: Afiaa Lateef

Mohammed Hassan, Ameer Emad

Mohammed Abd-Alghani, Mohammed Abd-Aljabar
 MAXILLARY OBTURATOR
IS A MAXILLOFACIAL PROSTHESIS THAT IS USED
TO CLOSE AND MAINTAIN THE INTEGRITY OF
THE ORAL AND NASAL COMPARTMENTS THAT
ARE ALTERED BECAUSE OF A CONGENITAL,
ACQUIRED, OR DEVELOPMENTAL DISEASE.

OFTEN, RECONSTRUCTIVE SURGERY ALONE IS

NOT ENOUGH TO RESTORE THE DEFECTS,
ESPECIALLY WHEN A DEFECT IS RELATIVELY
LARGE; HENCE, PROSTHETIC RECONSTRUCTION
MUST BE EMPLOYED.
INDICATIONS
1. TO ACT AS A FRAMEWORK OVER WHICH TISSUES
MAY BE SHAPED BY THE SURGEON.

2. TO SERVE AS A TEMPORARY PROSTHESIS

DURING THE PERIOD OF SURGICAL CORRECTION.

3. WHEN SURGICAL PRIMARY CLOSURE IS

CONTRAINDICATED.

4. WHEN A PATIENT'S AGE CONTRAINDICATES

SURGERY.
INDICATIONS
5. WHEN SIZE AND EXTENT OF THE DEFORMITY
CONTRAINDICATES SURGERY

6. WHEN LOCAL AVASCULAR CONDITION OF THE

TISSUES CONTRAINDICATES SURGERY.

7. WHEN A PATIENT IS SUSCEPTIBLE TO THE

RECURRENCE OF ORIGINAL LESION THAT
PRODUCED THE DEFORMITY
IDEAL REQUIREMENTS FOR
MAXILLARY OBTURATOR:
1. HELP THE PATIENT TO CARRY OUT NATURAL FUNCTIONS SUCH AS
PHONATION, DEGLUTITION, AND MASTICATION.
2. SHOULD EXHIBIT LIFE-LIKE APPEARANCE TO AID FUNCTION.
3. DESIGN OF THE PROSTHESIS SHOULD BE SUCH THAT IT IS EASILY AND
SWIFTLY PLACED AND HELD IN POSITION BOTH COMFORTABLY AND
SECURELY.
4. PROSTHESIS SHOULD BE DURABLE FOR A REASONABLE PERIOD OF
TIME, RETAIN ITS POLISH AND NISH.

5. SHOULD BE EASY TO CLEAN SO AS TO MAINTAIN HYGIENE.

THERE ARE VARIOUS FUNCTIONS OF OBTURATOR.

1. TO CLOSE THE DEFECT.

2. FOR FEEDING PURPOSE.
3. TO KEEP THE WOUND OR DEFECTIVE AREA CLEAN, THUS ENHANCE THE
HEALING OF TRAUMATIC OR POST SURGICAL DEFECTS.
4. AS A STENT TO HOLD DRESSINGS OR PACKS POST SURGICALLY.
5. TO REDUCE THE POSSIBILITY OF POSTOPERATIVE HAEMORRHAGE.
6. HELP TO RESHAPE AND RECONSTRUCT THE PALATAL CONTOUR AND/OR SOFT
PALATE.
7. IMPROVE SPEECH OR IN SOME INSTANCES, MAKES SPEECH POSSIBLE.
CLASSIFICATION OF OBTURATOR
1. ACCORDING TO ORIGIN OF THE DISCREPANCY:
A. FOR CONGENITAL DEFECT: TO CLOSE THE OPENING OF HARD PALATE, A
SIMPLE BASE PLATE TYPE OF PALATAL PLATE HELPS TO CORRECT THE
SWALLOWING, FEEDING, AND SPEECH.

B. FOR ACQUIRED DEFECT: IMMEDIATE TEMPORARY OBTURATOR OR

SURGICAL OBTURATOR IS A BASE PLATE TYPE OF PROSTHESIS WHICH IS
CONSTRUCTED FROM THE PREOPERATIVE ACTIVE IMPRESSION CAST AND
INSERTED AT THE TIME OF SURGERY, RESECTION OF THE MAXILLA IN THE
OPERATING ROOM.

INTERIM OBTURATOR, TEMPORARY OBTURATOR, TREATMENT OBTURATOR,

OR TRANSITIONAL OBTURATOR IS CONSTRUCTED FROM THE POSTSURGICAL
MASTER CAST
CLASSIFICATION OF OBTURATOR
CLASSIFICATION OF OBTURATOR
2. ACCORDING TO LOCATION OF THE DEFECT:

A. LATERAL OR BUCCAL OBTURATOR: CLOSES A DEFECT ON THE LABIAL OR

BUCCAL RIDGE AREAS.

B. ALVEOLAR OBTURATOR: CLOSES OPENING ON THE ALVEOLAR RIDGE.

C. HARD PALATE OBTURATOR: CLOSES OPENING CONTINUED WITHIN THE

ANATOMICAL LIMITS OF THE HARD PALATE WHEREAS SOFT PALATE
OBTURATOR CLOSES THE OPENING ON THE SOFT PALATE.

D. SOFT PALATE OBTURATOR: CLOSES THE OPENING ON THE SOFT PALATE.

CLASSIFICATION OF OBTURATOR
3. DEPENDING ON THE MATERIAL USED:

A. METAL OBTURATOR
B. RESIN OBTURATOR
C. SILICON OBTURATOR
MAXILLARY OBTURATOR TYPES:
A. IMMEDIATE SURGICAL OBTURATOR B.
TRANSITIONAL OBTURATOR
C. DEFINITIVE OBTURATOR

A. IMMEDIATE SURGICAL OBTURATOR

SURGICAL OBTURATOR IS DEFINED AS A TEMPORARY PROSTHESIS USED

TO RESTORE THE CONTINUITY OF THE HARD PALATE IMMEDIATELY
AFTER SURGERY OR TRAUMATIC LOSS OF A PORTION OR ALL OF THE
HARD PALATE AND/OR CONTIGUOUS ALVEOLAR STRUCTURE.
A. IMMEDIATE SURGICAL OBTURATOR

SURGICAL OBTURATOR, PLACED AT THE TIME OF TUMOUR RESECTION

IN THE OPERATING ROOM, PROVIDES THE SURGEON WITH AN
ANATOMICALLY ACCURATE, STABLE, CLEAN SCAFFOLD UPON WHICH
TO SUPPORT THE SURGICAL DRESSING.
B.TEMPORARY OR TRANSITIONAL OBTURATOR:

IT IS DEFINED AS A PROSTHESIS THAT IS MADE SEVERAL WEEKS OR MONTHS

FOLLOWING THE SURGICAL RESECTION OF A PORTION OF ONE OR BOTH
MAXILLAE. IT GENERALLY HAS NO TEETH. THIS PROSTHESIS WHEN USED
REPLACES THE SURGICAL OBTURATOR THAT IS PLACED IMMEDIATELY
FOLLOWING THE RESECTION AND MAY BE SUBSEQUENTLY REPLACED WITH
A DEFINITIVE OBTURATOR.
C.DEFINITIVE OBTURATOR

IT IS DEFINED AS A PROSTHESIS THAT

ARTIFICIALLY REPLACES PART OR ALL OF THE
MAXILLA AND THE ASSOCIATED TEETH LOST
DUE TO SURGERY OR TRAUMA.

WHEN SURGICAL INTERVENTIONS ARE

FINISHED, AND HEALING HAS
PROGRESSED FOR 4–6 MONTHS
FOLLOWING THE CESSATION OF ALL
THERAPY, INTERIM OBTURATOR CAN BE
REPLACED WITH A DEFINITIVE
OBTURATOR.
CONSTRUCTION OF THE
MAXILLARY OBTURATOR
1. TO PREPARE FOR THE FOLLOWING STAGES, WHICH
INCLUDE DUPLICATING, SURVEYING, AND
PROCESSING, THE MODELS AND CASTINGS THAT ARE
POURED INTO THE STONE SHOULD BE TRIMMED AND
CLEARED OF BUBBLES AND EXTRA PLASTER.

2. ACRYLIC RESIN, METAL ALLOYS, OR BOTH CAN BE

USED IN THE CONSTRUCTION OF THE MAXILLARY
OBTURATOR. WROUGHT WIRES , CAST, OR BOTH CAN
BE USED FOR THE RETENTIVE CLASPS. THE DESIGN OF
THE OBTURATORS CONSTRUCTED TO CORRECT
ACQUIRED PALATAL DEFECTS IS RELATIVELY SIMPLE.
 CONSTRUCTION OF THE
MAXILLARY OBTURATOR
3. IN DENTULOUS SITUATIONS, RETENTION IS
ACHIEVED BY THE POSTERIOR FLANGE AND CLASPS;
IN EDENTULOUS CASES, IT IS ACCOMPLISHED
THROUGH THE POSTERIOR FLANGE AND PERIPHERAL
AND POSTDAM SEAL.

4. FOR VERY SIGNIFICANT FLAWS, AN ADDITIONAL

RETENTION IS PROCURED BY MEANS OF A FLANGE, ITS
HINGE MECHANISM MAKES IT EASIER TO INSERT AND
REMOVE. WHILE SOME OBTURATOR DESIGNS MAY
REQUIRE BIGGER FLASK SIZES, THE PACKING AND
PROCESSING STEPS ARE THE SAME AS STANDARD
DENTURE BUILDING OPERATIONS.
 REFERENCES
1. CHALIAN VA, DRANE JB, STANDISH SM. MAXILLOFACIAL
PROSTHETICS. BALTIMORE: THE WILLIAMS AND WILKINS CO.; 1971.

2. DEBA K, YUNUS N, TAMRAKAR A. ORAL AND MAXILLOFACIAL

PROSTHETICS PART I: OBJECTIVES AND HISTORY. HEAL TALK 2012;4:18‑20.

3. RAHN AO, BOUCHER LJ. MAXILLOFACIAL PROSTHETICS: PRINCIPLES

AND CONCEPTS. SAUNDERS (W.B.) CO LTD, 1970

4. PARR GR, THARP GE, RAHN AO. PROSTHODONTIC PRINCIPLES IN THE

FRAMEWORK DESIGN OF MAXILLARY OBTURATOR PROSTHESES. J
PROSTHET DENT 1989;62:205-12.

5. LANG BR, BRUCE RA. PRESURGICAL MAXILLECTOMY PROSTHESIS. J

PROSTHET DENT 1967;17:613-9.

6. SCHAEFER K, TAYLOR TD. PALATAL LIFT PROSTHESIS RST DESCRIBED

BY GIBBONS AND BLOOMER IN 1958. CLINICAL APPLICATION OF PALATAL
LIFT. CLINICAL MAXILLOFACIAL PROSTHETICS. 1ST ED., CH. 9. CHICAGO:
QUINTESSENCE PUBLICATION CO, INC.; 2000. P. 133.

7. LAVELLE W, HARDY J. FOR TREATMENT OF PALATE‑PHARYNGEAL

INCOMPETENCE: PALATAL LIFT PROSTHESIS. J PROSTHET DENT
1979;42:308.

8. ECKERT S, DESJARDINS R, TAYLOR T. CLINICAL MANAGEMENT OF THE

SOFT PALATE DEFECT. CH. 8. CHICAGO: QUINTESSENCE PUBLICATION CO,
INC.; 2000. P. 125.