INTRODUCTION
Since the pa3ent underwent hemimaxilectomy surgery 8 years ago because of an Ossifiying Fibroma3(Fig. 1-‐3), she has an Aramany class I osseal defect3(Fig. 4). Once the permanent den33on was complete, the pa3ent underwent orthodon3c treatment for compensa3ng the occlusion of the remaining teeth (Fig. 5, 6). AOer the orthodon3c treatment was concluded, it was necessary to place a retainer, which could not be enamel-‐bonded because it would avoid the obturator to be placed in a passive way. As a result, it became necessary to develop an obturator who included the retainer.
CASE REPORT
The obturator was designed including a thick wire (0.40 in) for making the part of the retainer in the dentate arch (Fig. 7, 8), the thick of the wire was picked up aVending the durability and func3on needs of the obturator, since in this kind of pa3ents, it is complicated and painful to make an impression.
In order to give an extra reten3on to the obturator, aOer the loop, the wire of the retainer was contoured following the ves3bular convexity of the posterior teeth. In the anterior segment, it was made like a conven3onal retainer.
The obturator’s occlusion is in group func3on for providing stability in every movement of the mandible (Fig. 9, 10).
This design will be useful un3l the pa3ent concludes her growing stage with a good prognosis in order to give the pa3ent the opportunity of having a normal life according to her age.
DISCUSSION
A bonded retainer should not be used in this case, that is why the idea of adding it to the obturator was the key, making the elabora3on challenging.
This design is useful because it can be repeated and adapted to other oncologic pa3ents during the growing stage.
AKNOWLEDGEMENTS
The final result was successful once it achieved to combine an obturator with an orthodon3c retainer that gives the pa3ent back mas3catory func3on, phona3on and support to the soO 3ssues, while it maintains the teeth posi3on, allowing the pa3ent to be socially and familiarly accepted. (Fig. 11 – 14).
Prosthe(c Design of an Obturator with Orthodon(c Retainer: A Case Report Rosa de M. GUZMÁN*, Norma E. GUZMÁN, Blanca E. ESTRADA
Benemérita Universidad Autónoma de Puebla, Master Program in Oral Rehabilita(on. Puebla, México.
[email protected] ABSTRACT
An obturator was designed for restoring the edentulous hemimaxillar and retaining the natural teeth posi3on aOer orthodon3cs of a 15 year old female with leO hemimaxillectomy because of an Ossifying Fibroma1,2, who underwent orthodon3c treatment for achieving an appropriate occlusion of the remaining teeth. The final result was a successful obturator with orthodon3c retainer that gave the pa3ent back mas3catory func3on, phona3on and esthe3cs, and avoided movements of the already posi3oned teeth.
REFERENCES: 1. Mintz, Sheldon, Velez, Ines; “Central ossifying fibroma: An analysis of 20 cases and review of the literature”; Quintessence Interna3onal; Mar2007, Vol. 38 Issue 3.
Journal of Oral Rehabilita3on; 2005; No. 32. 2. R. Mesquita, S. Catanhede, M. Sousa, N. Soares; “Prolifera3ve ac3vity in peripheral ossifying fibroma and ossifying fibroma”; Journal of Oral Pathology & Medicine; 1998; Vol. 27. 3. Silvia Pérez García, Leonardo Berini Aytes, Cosme Gay Escoda; “Fibroma Osificante Maxilar: Presentación de un caso y revisión de la literatura”; Medicina Oral, Patología Oral, Cirugía Bucal ; 2004; Vol. 9; No. 4.
4. Roesch, R.L., Sierra, F.M., Estrada E.B.E., Fernández, T.R.; “Importancia clínica de un obturador Quirúrgico. Reporte de un caso”; Oral; Año 8, No. 24. 5. S. Koyama, K. Sasaki, T. Inai, M. Watanabe; “Effects of defect configura3on, size, and remaining teeth on mas3catory func3on in post-‐maxillectomy pa3ents”; Journal of Oral Rehabilita3on; 2005 Vol. 32. 6. Prosthe3c Rehabilita3on by Keith Thomas, P. 234-‐242.
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