Rehabilitation of Maxillectomy Defect with Palatal Obturator Using Digital Technology: A Review

Main Article Content

Mariska Juanita
Nur Inriany
Fitri Endang
Syakhrul Affandhy
Rahmat Alfian
Ike Damayanti Habar

Keywords

Maxillofacial Prosthetic, Palatal Obturator, Digital Technology

Abstract

This systematic review aimed to evaluate the masticatory, fonetic, aesthetic and psychological functioning of palatal obturator prosthesis fabricated using digital technology in patient with maxillectomy defect. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic search of the PubMed, PMC, Science Direct and Wiley databases was carried out in January 2022. The titles and abstracts of all articles were screened by two independent reviewers. The references of the subsequently selected studies were further screened for potential articles. Assessment of the selected full texts was performed independently according to established inclusion and exclusion criteria. A total of 10 studies were included with total of 251 patients. Obturator Functional Scale (OFS) for evaluation of the function was analyzed in 7 studies. Accuracy and dimensional differencies were analyzed in three other studies. From the limited number of studies, the patients showed good results in all fields of functional outcomes and social acceptance. The OFS scores were comparable with those reported in other studies using conventional method. CAD/CAM also tend to produce more extended dimension compared to original design, meanwhile conventional heat-cured PMMA palatal obturator show an overall reduction in dimensions with no significant difference and constant accuracy. CAD with RP technology in conclusion could possibly be an alternative and feasible method for manufacturing palatal obturators for patients after maxillectomy. It has shown significant clinical value, particularly with excellent accuracy and efficient working time.

Abstract 299 | PDF Downloads 409

References

1. Molinero-Mourelle P, Helm A, Cobo-Vázquez C, Lam W, Azevedo L, Pow E, et al. Treatment Outcomes of Implant-Supported Maxillary Obturator Prostheses in Patients with Maxillary Defects: A Systematic Review. Int J Prosthodont. 2020;33(4):429–40.
2. Neena A, Alshimy A, Khamis M, Ekram A. Digital Evaluation of Dimensional Accuracy and Intimacy of Fit of Single-Piece Closed Hollow Bulb Obturators Fabricated By Cad/Cam Additive Manufacturing. Alexandria Dent J. 2020;45(1):68–74.
3. Sabol J V., Grant GT, Liacouras P, Rouse S. Digital Image Capture and Rapid Prototyping of the Maxillofacial Defect. J Prosthodont. 2011;20(4):310–4.
4. Tanveer W, Ridwan-Pramana A, Molinero-Mourelle P, Koolstra JH, Forouzanfar T. Systematic review of clinical applications of cad/cam technology for craniofacial implants placement and manufacturing of nasal prostheses. Int J Environ Res Public Health. 2021;18(7).
5. Moreno Soriano C, Castañeda Vega P, Estrugo Devesa A, Jané Salas E, López López J. Frequency and type of digital procedures used for the intraoral prosthetic rehabilitation of patients with head and neck cancer: A systematic review. J Prosthet Dent [Internet]. 2021;1–5.
6. Ye H, Ma Q, Hou Y, Li M, Zhou Y. Generation and evaluation of 3D digital casts of maxillary defects based on multisource data registration : A pilot clinical study. J Prosthet Dent [Internet]. :1–6.
7. Huang Z, Wang X, Hou Y. Novel Method of Fabricating Individual Trays for Maxillectomy Patients by Computer-Aided Design. 2015;24:115–20.
8. Jiang F, Hoy Y, Lu L, Ding Xi, Li W, Yan A. Functional Evaluation of a CAD / CAM Prosthesis for Immediate Defect Repair after Total Maxillectomy : A Case Series of 18 Patients with Maxillary Sinus Cancer. J Esthet Restor Dent. 2015;27:80–90.
9. Jiao T, Zhu C, Dong X, Gu X. Prostheses Fabricated Using Computer-Aided Design and. 2014;480–6.
10. Waseem M, Khan U, Shah AALI, Fatima A, Hanif A. Subjective assessment of obturator functioning in patients with hemimaxillectomy Subjective Assessment of Obturator Functioning in patients with Hemimaxillectomy. 2018;(August).
11. Ozdemir-karatas M, Balik A, Evlioglu G, Uysal Ö. Predictors of obturator functioning and satisfaction in Turkish patients using an obturator prosthesis after maxillectomy. Oral Surg Oral Med Oral Pathol Oral Radiol [Internet]. 2017;1–7. Available from: https://doi.org/10.1016/j.oooo.2017.11.002
12. Ali MM, Khalifa N, Alhajj MN. Quality of life and problems associated with obturators of patients with maxillectomies. 2018;1–9.
13. Naz F, Bali SK. Assessment of obturator functioning in Kashmiri patients rehabilitated with an obturator prosthesis post hemi-maxillectomy : A cross-sectional study. 2019;5(3):107–10.
14. Chen C, Ren W, Gao L, Cheng Z, Zhang L, Li S, et al. Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation. Braz J Otorhinolaryngol [Internet]. 2016;82(2):177–83.
15. Park J-H, Lee K-S, Lee J-Y, Shin S-W. Fabricating a Maxillary Obturator Using an Intraoral Digital Impression: A Case History Report. Int J Prosthodont. 2017;30(3):266–8.
16. Akay C, Yaluğ S. Biomechanical 3-dimensional finite element analysis of obturator protheses retained with zygomatic and dental implants in maxillary defects. Med Sci Monit. 2015;21:604–11.
17. Elbashti ME, Hattori M, Patzelt SBM, Habil MD, Schulze D, Sumita YI, et al. Feasibility and Accuracy of Digitizing Edentulous Maxillectomy Defects: A Comparative Study. 2017;30(2):147–9.
18. Soltanzadeh P, Su JM, Habibabadi SR, Kattadiyil MT. Obturator fabrication incorporating computer-aided design and 3-dimensional printing technology: A clinical report. J Prosthet Dent [Internet]. 2019;121(4):694–7. 19. Rodney J, Chicchon I. Digital Design and Fabrication of Surgical Obturators Based Only on Preoperative Computed Tomography Data. Int J Prosthodont. 2017;30(2):111–2.
20. Elbashti M, Sumita Y, Hattori M, Aswehlee A, Taniguchi H. The Role of Digitization in the Rapid Reproduction of an Obturator in a Frail Elderly Patient. Int J Prosthodont. 2016;592–4.
21. Tasopoulos T, Chatziemmanouil D, Kouveliotis G, Karaiskou G, Wang J, Zoidis P. PEEK Maxillary Obturator Prosthesis Fabrication Using Intraoral Scanning, 3D Printing, and CAD/CAM. Int J Prosthodont. 2020;33(3):333–40.
22. Michelinakis G. The use of cone beam computed tomography and three dimensional printing technology in the restoration of a maxillectomy patient using a dental implant retained obturator. J Indian Prosthodont Soc. 2017;17(4):406–11.
23. Kortes J, Dehnad H, Kotte ANT, Fennis WMM, Rosenberg AJWP. A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy. Int J Oral Maxillofac Surg [Internet].2018;47(9):1214–8.
24. Palin CL, Huryn JM, Golden M, Booth PR, Randazzo JD. Three-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report. J Prosthet Dent [Internet]. 2019;121(2):353–7.