Three Fixation Techniques of Immediate Surgical Obturators Following Maxillectomy - A Comparative Study

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Engineering
• Reconstructive Surgery

Background:

• Conventional surgical obturators remain prevalent in maxillectomy cases due to limitations in microvascular surgery, including poor outcomes and financial constraints.
• Immediate surgical obturators are crucial for restoring function and aesthetics after maxillary resection.

Purpose of the Study:

• To compare and evaluate three distinct fixation techniques for immediate surgical obturators in maxillectomy patients.
• To assess the efficacy of screw-based, clasp-based, and material-based fixation methods.

Main Methods:

• A study involving 56 maxillectomy cases over 33 months (January 2021 - August 2023).
• Evaluation of fixation techniques based on fabrication duration, intraoperative stability, post-operative function, tissue healing, and biocompatibility.
• Minimal follow-up period of 3 months for all cases.

Main Results:

• The screw-based technique demonstrated superiority across most evaluated criteria.
• Clasp-based and material-based techniques showed comparatively lesser efficacy.
• Peak incidence of maxillectomy was observed in the fourth and fifth decades, with diverse etiologies including infections and carcinoma.

Conclusions:

• The screw-based fixation technique provides significant advantages, including ease of fabrication, surgeon convenience, biocompatibility, and improved patient quality of life.
• This technique is also suitable for edentulous patients and those requiring extensive surgery or extraoral support.