Maxillofacial Prosthetics Question And Answers

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Maxillofacial Prosthetics

 

Maxillofacial Prosthetics Definition

Obturator: “A prosthesis used to close a congenital or acquired tissue opening, primarily of the hard palate and/or contiguous alveolar structures”.

Surgical obturator: It is defined as “A temporary prosthesis used to restore the continuity of the hard palate immediately after sur- gery or traumatic loss of a portion or all of the hard palate and/or contiguous alveolar structures”.

Interim 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 frequently includes replacement of teeth in the defect area.’

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”.

Maxillofacial Prosthetics Important Notes

1. Types of obturator

  • Types:
    • Based on the phase of treatment
      1. Surgical Obturators -Types:
        • Immediate surgical obturator – Inserted at the time of surgery
        • Delayed surgical obturator – Inserted 7–10 days after surgery
      2. Definitive obturators
      3. Interim Obturators
    • Based on the Material used
      • Metal obturators
      • Resin obturators
      • Silicone obturators
    • Based on the area of restoration
      • Palatal obturator
      • Metal obturator

2. Materials used in maxillofacial prosthesis:

  • Heat cure acrylic resin
  • Polyvinyl chloride and copolymers
  • Polyurethane elastomers
  • Silicones
  • Polyphosphates
  • Chlorinated polyethylene

Maxillofacial Prosthetics Short Essays

Question 1. Treatment Planning for a maxillary prosthesis.
Answer:

  1. First Phase – Initial Stabilization
    • It lasts for 2 weeks
    • The physician determines the prognosis
  2. Second Phase – Early management
    • It extends for 2–8 weeks
    • Treatments like inter maxillary Fixation, Splinting, and RCT are done
  3. Third Phase – Intermediate management
    • It extends for 3–8 months
    • A treatment prosthesis is provided and defects are evaluated
  4. Fourth Phase – Definitive management
    • It extends from 6 months – 3 years
    • A permanent prosthesis is fabricated

Read And Learn More: Prosthodontics Question And Answers

Question 2. Obturators.
Answer:

Definition: “A prosthesis used to close a congenital or acquired tissue opening, primarily of the hard palate and/or contiguous alveolar structures”.

Types of Obturators:

1. Based on the phase of treatment:

  • Surgical Obturators: It 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 structures”.
    • Types:
      1. Immediate surgical obturator:
        • Inserted at the time of surgery
      2. Delayed surgical obturator: Inserted 7 -10 days after surgery
        • Interim Obturators: 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 frequently includes the replacement of teeth in the defect area.
          • This prosthesis when used, replaces the surgical obturator that is placed immediately following the resection and may be subsequently replaced with a definitive obturator”.
        • Definitive obturators: 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”.

2. Based on the Material used:

  • Metal obturators
  • Resin obturators
  • Silicone obturators

3. Based on the area of restoration:

  • Palatal obturator
  • Metal obturator

Fabrication of Obturators:

  • Plan the design and extent of the obturator
  • Primary impression is made
  • Fabricate the custom tray
  • Carry out border molding by asking the patient to swallow
  • The final impression is made using alginate or elastomeric impression materials
  • Record the jaw relation and arrange the teeth. Insert the prosthesis

Uses of Obturators:

  • Provides stable matrix for surgical packing
  • Reduces oral contamination
  • Effective speech obtained post-operatively
  • Permits deglutition
  • Reduces the psychological impact of surgery
  • Reduce the period of hospitalization

Question 3. Materials for a maxillofacial prosthesis.
Answer:

1. Acrylic resin: Preferred for restoring defects that require minimal movement

Advantages of Acrylic resin:

  • Easily available
  • Commonly used material
  • Intrinsic and extrinsic colouration can be used
  • Has better colour stability

Disadvantages of Acrylic resin:

  • Rigid
  • Difficulty in duplicating

2. Acrylic copolymers: They are plasticized methyl meth acrylate polymers that are not commonly used

Disadvantages of Acrylic copolymers:

  • Tacky so leads to a collection of dust and stains
  • Poor edge strength
  • Poor durability
  • Degrades under sunlight

3. Polyvinyl chloride and copolymers: It is a hard, clear, tasteless, and odorless resin

Disadvantages of Polyvinyl chloride and copolymers:

  • Excessive shrinkage
  • Long processing time
  • Discoloration
  • Hardening of the margins

4. Chlorinated polyethylene:

  • It requires metal molds for processing

5. Polyurethane elastomers:

  • Have excellent elasticity
  • Used to restore defects
  • Has moisture sensitivity during processing
  • Poor colour stability

6. Silicones: The most commonly used material

  • Types:
    • Implant grade
    • Medical grade
    • Clean grade
    • Industrial grade

7. Polyphosphates:

8. Adhesives:

  • Used to retain a maxillofacial prosthesis

9. Metal:

  • Used to obtain bone anchorage for a prosthesis

Maxillofacial Prosthetics Viva Voce

  1. The interim obturator can serve up to 6 months
  2. The goal of the interim obturator is to restore deglutition and speech
  3. The surgical obturator is used for approximately 5 days

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