A Simplified Technique for Constructing One Piece Hollow Obturator after Partial Maxillectomy

Acquired surgical defects of the hard or soft palates interfere with the speech pattern and the mechanism of deglutition, and of equal importance, produce a feeling of social insecurity with unfavorable psychological as well as economic consequences. Patients with palatal defects labor under handicaps that cannot be fully appreciated by those with normal palates. The dentist should use his specialized training and prosthetic abilities to treat those persons who need the precise type of prosthesis required to correct acquired openings of the hard and soft palate. Acquired openings of the hard and soft palate may be a result of trauma, disease, pathologic changes, radiation burns, or surgical intervention. The opening produced may be quite small or it may include any portion of the hard and soft palate, the alveolar ridges, and the floor of the nasal cavity. There are two important reasons for correcting the acquired palatal defect as soon as possible. First, the physical development and wellbeing of the patient will be protected, and, second, the morale and mental development of the patient will be greatly improved.1 A myriad of methods has been employed for producing a hollow obturator. The classic method is to process a solid speech aid and subsequently grind out the unwanted portion. This necessitates a covering for the space that has been ground out. A variation is to shim the defect of the cast and simulate the ridge contour in clay. A wax template for the capping of the obturator is made. Again, both have to be processed and ultimately attached with autopolymerizing acrylic resin. Chalian and associate suggested a one piece hollow obturator which necessitates the making of a hollow shim around which the obturator is processed. Others have suggested a two flask investing technique with an autopolymerizing seal between the two halves. All of these methods are long and tedious and require the assistance of a knowledgeable dental laboratory technician.2 The weight of the maxillary obturator is a dislocating factor because the prosthesis often acts as a cantilever. The laboratory procedure generally used in the construction of a hollow obturator is rather complicated.3 In this case report a patient who had undergone hemimaxillectomy was rehabilitated with a hollow bulb obturator using a simplified technique.