Management of Palatal Defect Post Hemimaxillectomy: A Case Report

Abstract

Patient chief complaint: A 42-year-old woman was referred to Prosthodontic Department Hasanuddin University Dental Hospital with speaking, swallowing, and chewing difficulty caused by fractured acrylic obturator that could not be reused. Since the resection of maxillary tumor in 2012, the patient has been using an obturator, resulting in a significant and deep defect in the right maxillary region Patient status: Intraoral examination showed a defect in the midline of the palate extending to the left alveolar bone, and edentulous are 21, 22, 23, 24, 25, 26, 27 and 16. The maxillary defect did not appear to be inflamed or infected, and the surrounding area appeared to be normal. Treatment plan: Fabrication of maxillofacial framework partial denture to rehabilitate maxillary abnormalities. This material was chosen because its biocompatibility and rigidity. Details of therapy: Primary impression was carried out with irreversible hydrocolloid material with a stock tray to obtain a study model. Custom tray was made for individual impression with polyvinyl siloxane material to get a working model. Surveying was done then framework and bite rim were made. Maxillary denture designed with Akers clasps on 35, 37, RPI on 45, full palatal palate as major connector. After that, try in framework, followed by determine the vertical dimension. Arrangement of artificial teeth in articulator using A3 shade. The next appointment was try in prosthesis by evaluate retention, articulation, phonetics and esthetics, then sent to the dental lab for processing, the obturator were then inserted in patient mouth. Patient was followed up 24 hours and 1 week after insertion. Clinical significance: Maxillofacial framework partial denture is a rehabilitation device that can produce decent of retention and stabilization, especially in acquired defect cases. Prosthesis can improve patient’s adaptation and ability with the functions of speech, mastication, and ingestion.