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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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