Influences of Size and Form of Maxillectomy Defect, and Remaining Maxillary Teeth on Oral Functions of Patients Receiving Prosthetic Therapy with Obturator
International Journal of Dental Medicine
Volume 1, Issue 1, April 2015, Pages: 1-7
Received: Apr. 12, 2015;
Accepted: Apr. 21, 2015;
Published: Apr. 24, 2015
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M. S. Islam, Department of Prosthodontics, Rangpur Dental College & Hospital, Rangpur, Bangladesh
M. M. Rahman, Department of Prosthodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Piarul Islam, Department of Prosthodontics, Dhaka Dental College & Hospital, Dhaka, Bangladesh
Ashraful S. M. Hayet, Department of Dentistry, Rangpur Medical College Hospital, Rangpur, Bangladesh
Syed A. Rahman, Dental Unit, Sir Salimullah Medical College, Dhaka, Bangladesh
M. S. Azam, Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Background: Maxillectomy defect causes an oro-nasal opening affecting oral functions; inability to chew and swallow disorders in phonation, aesthetics and psychological depression of patients. Obturator prosthesis can result improvement in oral functions by re-establishing oro-nasal separation. Objectives: The study was done to investigate the effects of maxillary defect form, size, and remaining maxillary teeth on oral functions in post-maxillectomy patients. Materials and Methods: The study was conducted over 16 post-maxillectomy patients, age (mean±SD = 37.56±13.07 years) ranged from 18 to 70 years, male 9(56.20%) and female 7(43.80%), partially dentate, treated with obturator prosthesis at the prosthodontic department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. All patients had continuously worn the obturator prostheses for at least 3 months during the study. Data of each patient were recorded on the basis of size and form of maxillary defect, and remaining maxillary teeth, and mastication, speech and swallowing. The data were tested with statistical software (SPSS V.19). Results: Form and size of the maxillectomy defect has significant relationship with the masticatory performance (P= .007 for defect form & .003 for defect size) and articulation of speech (P= .003 for defect form & 0.001 for defect size). Remaining maxillary teeth has no significant relation to masticatory performance (P = .66) and articulation of speech (P = .386). Form and size of the maxillectomy defect, and remaining maxillary teeth has no significant relationship with the swallowing obturator function (P-value= .13 for defect form .09 for defect size and .49 for remaining teeth). Conclusion: Size and form of maxillary defect significantly influence the masticatory performace and articulation of speech, they also affect in swallowing efficacy but it is not statistically significant. Remaining maxillary dentition has not significant effects on oral function of obturator.
M. S. Islam,
M. M. Rahman,
Ashraful S. M. Hayet,
Syed A. Rahman,
M. S. Azam,
Influences of Size and Form of Maxillectomy Defect, and Remaining Maxillary Teeth on Oral Functions of Patients Receiving Prosthetic Therapy with Obturator, International Journal of Dental Medicine.
Vol. 1, No. 1,
2015, pp. 1-7.
Kiran KT, Suchita T, Anulekha ACK and Rajyalakshmi R. A prosthodontic rehabilitation of a partial maxillectomy patient with hollow bulb obturator. IJDA 2010; 2(4), 383-6
Khan Z. An overview of oral cancer in Indian subcontinent and recommendations to decrease its incidence. Webmed Central CANCER 2012; 3(8): WMC003626
Akhter M, Ali L, Hassan Z & Khan I. Association of human papilloma virus infection and oral squamous cell carcinoma in Bangladesh. J Health, Population and Nutrition 2013; 31(1): 65-9
Azam SM, Rahman BQ, Akhter M, Hossain SM, Asadullah M, Rahman AS, Islam SM. Detection of cervical lymphnode metastasis in oral squamous cell carcinoma by ultrasonogram guided fine needle aspiration cytology (FNAC) and comparison with computed tomographic (ct) findings. KhwajaYunus Ali Med Coll J 2014; 4(2): 391-7
Koyama S, Sasaki K, Inai T, Watanabe M. Effects of defect configuration, size, and remaining teeth on masticatory function in post-maxillectomy pataients. J oral Rehabil 2005; 30:635-41.
Dhiman R. Rehabilitation of a rhinocerebral mucoromycosis patient. Indian J Proshod Soc. 2007; 7:88 91.
Tirelli G, Rizzo R, Biasotto M, Di Lenarda R, Argenti B, Gatto A, Bullo F. Obturator prostheses following palatal resection: clinical cases; ACTA otorhinolaryngologica italica 2010; 30:33-9
Hayet SMA, Islam MS, Azam MS, Rahman SA, Rahman MM and Akhter M. Prosthetic rehabilitation of acquired total maxillectomy patient with obturator prosthesis – a case report. Bangladesh Dent J 2011; 27:36-8.
Roumananas ED, Nishimura RD, Davis BK, Beumer J III. Clinical evaluation of implants retaining edentulous maxillary obturator prostheses. J Prosthet Dent. 1997; 77:184–19.
Chalian VA, Drane JB & Standish SM Maxillofacial Prosthetics. Multidisciplinary practice, The Williams & Wilkins Co., Baltimore 1971; pp. 133-148.
Keyf F. Obturator prostheses for hemimaxillectomy patients. J Oral Rehabil 2001; 28:821–29
Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW, Shah JP, Spiro RH, Holland JC. Quality of life of maxillectomy patients using anobturator prosthesis. Head Neck. 1996; 18:323–34.
Islam MS, Rayhan MA, Hayet SMA. Obturator prosthesis for post-maxillectomy patients. Rangpur Dent Coll J 2013; 1(2): 26-31.
Parr GR, Tharp GE & Rahn AO. Prosthetic principle of the framework design of maxillary obturator prostheses. J Prosthet Dent 1989; 62: 205-12.
Curtis TA, Beumer JIII. Restoration of acquired hard palate defects: etiology, disability and rehabilitation. In: Beumer J III, Curtis TA, Marunick MT , editors. Maxillofacial rehabilitation.prosthodontic and surgical considerations. St. Louis: Medico Dental Medico Intl; 1996. p. 225-84
Ernest L. DaBreo. Chapter 80: Maxilloacial Prosthetic Rehabilitation of Acquired Defects. www.famona.tripod.com/ent/cummings/cumm080.pdf Down loaded on 14/11/2013
Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: Classification. J Prosthet Dent. 1978; 40:554–7.
Takahiro O, Hideli K, Kazuhiro H & Takashi N. Masticatory performance in postmaxillectomy patients in edentulous maxillae fitted with obturator prostheses. Int J Prosthodont 2007; 20:145-50
Takahiro O, Hideli K, Kazuhiro H & Takashi N. Predecive factors of Masticatory performance in postmaxillectomyobturator wearer with soft palate defect that is either absent or limited to the anterior part. Prosthodont Res pract 2007; 6:181-187.
Yamashita S, Sakai S, Hatch JP & Rugh JD. Relationship between oral function and occlusal support in denture wearers. J Oral Rehabili 2000; 27: 881–6.
Yeshino K, Kikukawa I, Yoda Y, Watanabe H, Fukai K, Sugihara N, Matsukubu T. Relationship between Eichner index and number of present teeth. Bull Tokyo Dent Coll 2012; 53(1): 37-40
Rahman MM, Sultana A, Rahman MM, Haider IA; Difference of techniques for preparation of obturators in Bangladesh, J Oral Health 2005; 7(1):24-8
Sato Y, Minagi S, Akagawa Y, Nagasawa T. An evaluation ofmasticatory function of complete denture. J Prosthet Dent.1989; 62:50–53.
Islam MS, Chowdhury F, Nessa J, Rahman MM, Azam MS and Hayet SMA. Effectiveness of obturator with radicular attachment on masticatory performance of patients following maxillectomy. Bangladesh Med Coll J 2013; 18 (1): 19-23.
James F, Lubker, James W, Schweiger. Nasal Airflowas an Index of Success of Management of Cleft palate.J Dent Res 1969;48:368.http://dx.doi.org/10.1177/00220345690480030801
Islam MS, Chowdhury F, Yazdi KS, Azam MS, Rahman MM, Nessa J. Articulation of speech of patients treated with radicular attachment assisted obturator following maxillectomy. Bangladesh J Med Sc 2014; 13(3): 298- 301. doi:10.3329/bjms.v13i3.19152
Jacob RF, Maxillofacial prosthodontics for the edentulous patient; Zarb GA, Bolender CL, Prosthodontic treatment for edentulous patients; St.luis, Mosby; 2004. p-453
Sema M, Ayhan G, Abufaz I, Bahadir D, Unsun C. Enhanced retention of a maxillofacial prosthetic obturator using precision attachments: Two case reports. Eur J Dent 2012; 6:212-7.
Yue ZH, Zhi H, Hong QY and Yong SZ. Inflatable hollow obturator prostheses for patientsundergoing an extensive maxillectomy: a case report. Int J Oral Sc 2012; 4:114–8; doi:10.1038/ijos.2012.22
Wu YL, Schaaf NG. Comparison of weight reduction in different designs of solid andhollow obturator prosthesis. J Prosthet Dent 1989; 62(2): 214–217.
Oh WS, Roumanas ED. Optimization of maxillary obturator thickness using a double processing technique. J Prosthodont 2008; 17(1): 60–63.
Hüseyin K, Hamit SҪ, Övül K, Faith Ö. Evaluation of speech intelligibility with maxillary resection obturators: a clinical study. SÜ Dişhek Derg 2007; 16:10-4.
Adisman IK. Prosthesis serviceability for acquired jaw defects. Dent Clin North Am. 1990;34:265–284.
Aramany MA, Drane JB. Effect of nasal extension sections on the voice quality of acquired cleft palate patients. J Prosthet Dent.1972; 27:194–202.
Oral K, Aramany MA, McWilliams BJ. Speech intelligibility with the buccal flange obturator. J Prosthet Dent. 1979;41:323–328.
Suha T, Timucin B, Asim AM and Mustafa OM. Articulation performance of patients wearing obturators with different buccal extension designs. Eur J Dent. 2009; 3(3): 185–90.
Brown KE. Peripheral consideration in improving obturator retention. J Prosthet Dent. 1968; 20:176–81
Viviane de CT, Maria IPK, José RPL. Speech evaluation with and without palatal obturator in patients submitted to maxillectomy. J Appl Oral Sci. 2006; 14(6):421-6
Bohle G 3rd, Rieger J, Huryn J, Verbel D, Hwang F, Zlotolow I. Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacy-clinical assessments and cephalometric analysis: a Memorial Sloan-Kettering Study. Head Neck 2005; 27(3):195-207.
Sullivan M, Gaebler C, Beukelman D, Mahanna G, Marshall J, Lydiatt D, et al. Impact of palatal prosthodontic intervention on communication performance of patients maxillectomy defects: a multilevel outcome study. Head Neck. 2002; 24(6):530-8.
Arigbede AO, Dosumu OO, Shaba OP, Esan TA. Evaluation of speech in patients with partial surgically acquired defects: pre and post prosthetic obturation. J Contemp Dent Pract 2006; (7)1:089-096.
El-Dakkak M. Adequacy of velopharyngeal closure and speech competency following prosthetic management of soft palate resection. Saudi Dent J 1991; 3(1): 3-7.