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A Ten-Year Prosthetic Story of A Hemimaxillectomy Patient
Purpose: Patients who have maxillofacial defects caused by removal of benign/malign pathologies of mid-face have a negative impact on life quality due to lack of esthetics, phonation and deglutition. Obturator prostheses retained with different retention elements are the most effective way of rehabilitating such cases. This clinical report describes 2 different obturator prosthesis treatment of a hemimaxillectomy patient in 10-years period. Case Report: A 47-year-old female patient reported with a chief complaint of missing teeth in upper jaw. Primary concerns were; poor aesthetics, phonation, deglutition problems and regurgitation of food in nasal cavity. Patient was diagnosed with carcinoma at maxilla for which a hemimaxillectomy was performed followed by postsurgical radiation therapy in 2011. Intraoral examination showed palatal defect on the left side involving hard palate, alveolar ridge and dentition to midline. On non-defect side, some teeth were existing. The patient was rehabilitated with a precision-attachment-retained removable partial obturator prosthesis (RPOP). Ten years later, patient referred to clinic because of pain at remaining teeth that were retaining the old obturator prosthesis. In clinical examination, it was observed that remaining abutment teeth had mobility and caries. Teeth with mobility were extracted and tooth #17 was left as a supporting abutment under denture for retention and stabilization of new denture. The patient was retreated with conus crown supported overdenture obturator prosthesis. Results: The patient had no complaints about aesthetic, function and phonation after prosthetic rehabilitation after 6-months follow-up period, as in first rehabilitation with precision-attachment-retained RPOP in 10-years clinical usage. Conclusion: Such a defect causes a lot of psychological trauma to the patients due to impaired esthetics and functions. Hence, the prosthodontists try to restore the lost form and function of the oral and perioral structures that will enable the patients to gain patients’ comfort and confidence. Keywords: Hemimaxillectomy, obturator prosthesis, overdenture, precision attachment, retention.