Prosthetic rehabilitation of a complete bilateral maxillectomy patient using a simple magnetically connected hollow...

The purpose of this clinical report is to present a description of the prosthetic rehabilitation of a bilateral complete maxillectomy patient using a two piece magnetically connected prosthesis.

A complete bilateral maxillectomy defect presents a considerable reconstructive challenge for the prosthodontist. It results in devastating effects on cosmetic, functional, and psychological aspects of the patient.

A 46-year-old woman reported with a chief complaint of missing teeth in the upper jaw. Her primary concerns were a poor facial appearance, inability to chew food, and regurgitation of the food into the nasal cavity. She was diagnosed with carcinoma of the maxillary sinus, for which a bilateral maxillectomy was done followed by post surgical radiation therapy. The prosthetic treatment objectives were to separate the nasal and oral cavities, restore the mid-facial contour, and improve her masticatory functions by providing a full complement of maxillary teeth using a two-piece connected hollow obturator prosthesis connected by a magnet.

Insertion and removal of a large prostheses used for rehabilitation of midfacial defects requires good neuromotor coordination and an adequate mouth opening. Because these factors were problematic for this patient, the treatment plan was to fabricate a two piece magnetically connected prosthesis. After fabrication and insertion of the prosthesis, the fit between two sections was evaluated and instructions for insertion, removal, and maintenance of the obturator were given. The patient's speech, masticatory efficiency, and swallowing dramatically improved after insertion.