OPPORTUNITIES FOR TREATMENT WITH A TEMPORARY OBTURATOR MADE OF THERMOPLASTIC FOIL

Abstract

Prosthetic treatment with a temporary obturator is an intermediate stage in the overall prosthetic rehabilitation of patients with maxillary resection. According to prevailing opinions, treatment with a temporary obturator should start around 2 weeks to 2-3 months after resection and to continue until the final completion of the healing processes in the defect. Due to the dynamic changes in the defect, this treatment stage is associated with many difficulties, requiring frequent correction of the obturator and up to 12-14 clinical visits on average. The aim of the research is to track the opportunity for fabrication of a temporary obturator of thermoplastic foil with vacuum forming apparatus and its efficiency for restoring speech and fluid intake in patients with maxillary resection. For the aim of the study we conducted a treatment of a 45-year-old patient operated a week ago for maxillary carcinoma. As a result, the left alveolar bone and a part of the hard palate with a diameter of 10 mm were resected, with teeth 13 to 23, 16 and 17 preserved. The defect was padded with gauze and an impression with an irreversible hydrocolloid impression material was taken. In the laboratory a grade 4 plaster working model was cast on which the borders of the palatal plate were outlined. For the frontal teeth, these were the cervical areas of the teeth, and for the distal - their equators. In the area of the defect and the missing teeth the border reached the transitional fold, and distally - the soft palate. The plate was made from foil of 1 mm diameter which was drawn onto the model with a vacuum forming apparatus and was cut along the indicated borders. The palatal plate - obturator successfully closed the comunication to the nasal cavity and restored the opportunity for fluid intake, which was the main problem for the patient. The use of a foil with a thickness of 1 mm provided stability and resistance of the construction. As a result of this, the necessary hermetic seal of the defect was achieved and the speech of the patient was normalised. The described treatment methodology with a temporary obturator allows the successful restoration of speech and fluid intake during the healing processes in the defect. The main advantages of the method are the fast and easy fabrication, the opportunity for multiple corrections and the short period of adaptation.