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Prosthetic rehabilitation offers the choice of regaining cosmesis and functional integrity while improving
an individual's quality of life after or during surgical management of neck and head cancer. The
prosthesis utilized to shut an opening of a patient's hard palate is referred to as an obturator. The
primary goals of prosthetic rehabilitation includes providing an obturator prosthesis which restores
orofacial functions, like control of secretions, deglutition, mastication and phonetics, and additionally to
aesthetically replace orofacial structures that are missing. maxillofacial prosthetics
Planning for Treatment
Initial preparation for patients planning to undergo treatment of neck and head cancer ought to include
assessment by a prosthodontist. Even if the surgical reconstruction is pre-planned, a dental prosthesis
might be considered as a portion of the definitive rehabilitation.
A full orofacial exam must be done. The surgical preparation and the postsurgical complications which
must be addressed prosthodontically ought to be explained to a patient. During this time, an in-depth
assessment of the existing dentoalveolar condition must be undertaken. Periodontal and restorative
treatments and extractions must be planned. Depending upon the preliminary resection design, even
compromised teeth must potentially be considered as supports for the prosthesis.
Splinting teeth using a traditional bridge or supracrestal bar may prove advantageous for retention,
support, as well as stability of the removable obturator. But, torquing forces must be assessed and the
design changed accordingly. Preexisting conditions which might impact upon successful prosthodontic
outcome also should be assessed and corrected before definitive surgery. Preexisting fixed partial
dentures which cross the planned resection cut easily are sectioned before the planned operation.
Considerations for Surgery
The main goal of surgery includes the full eradication of a tumor that requires enough surgical margins
to decrease the local recurrence risk. Adjacent structures must be resected if needed to reach negative
margins. But, some surgical precautions taken may result within a postoperative defect which may be
efficiently obturated prosthetically. ocular prosthetic
Palatal mucosal incision- An easy consideration which possesses a positive impact upon prosthesis
function includes providing for a band of keratinized palatal mucosa in order to cover the medial
element of an exposed residual bony palate. It may be achieved by making the main palatal mucosal
incision at the minimum of 5 millimeters lateral to an osseous incision. The loose band of dense
keratinized tissue then can be sutured to the nasal floor, covering the bony palate that is medially
exposed. The space will form the fulcrum for rotation of an obturator prosthesis, as well as keratinized
tissue is going to more favorably accept friction from a prosthesis than the non-keratinized nasal
mucosa. The split-thickness skin graft must be considered if the keratinized palatal mucosa isn't