21076 Impression and custom preparation; surgical obturator prosthesis

Name of the Procedure:

Impression and Custom Preparation: Surgical Obturator Prosthesis
Common name: Surgical Obturator, Custom Obturator Prosthesis

Summary

This procedure involves creating a custom-made surgical obturator prosthesis for patients who have undergone maxillary surgery, often due to tumor removal. It entails taking an impression of the surgical site and fabricating a prosthesis to fit the specific anatomical needs of the patient.

Purpose

The procedure addresses defects or holes in the maxillary region of the mouth, often caused by surgery for cancer removal. The goal is to restore normal function, improve speech, facilitate swallowing, and enhance cosmetic appearance.

Indications

• Patients who have undergone maxillectomy (removal of part or all of the maxilla)
• Presence of defects in the maxillary region due to trauma, congenital defects, or infection
• Difficulty in speaking, chewing, or swallowing due to maxillary defects

Preparation

• Patients may need to fast for a few hours before the procedure.
• Pre-operative imaging studies like CT scans or MRIs may be required.
• Pre-procedure dental evaluation and consultations with the surgical and prosthodontic teams.

Procedure Description

1. Initial Consultation:
   • A thorough examination of the surgical site.
   • Discussion of patient needs and expectations.
2. Impression Taking:
   • Application of a suitable impression material to the defect area to create an accurate mold.
3. Creation of Prosthesis:
   • The impression is sent to a dental laboratory where the custom obturator is fabricated.
4. Fitting and Adjustment:
   • The prosthesis is tried in the patient's mouth, and adjustments are made for comfort and function.
5. Final Placement:
   • The patient returns for the final fitting, and any necessary refinements are made.

Tools: Impression trays, impression material, dental laboratory equipment
Anesthesia: Local anesthesia may be used during impression taking if needed.

Duration

The initial procedure typically takes about 1-2 hours, while the overall process from impression to final fitting may take several weeks.

Setting

This procedure is performed in a dental clinic or an outpatient setting within a hospital.

Personnel

• Prosthodontist or maxillofacial prosthodontist
• Dental technicians
• Surgical team (if adjustments or additional surgeries are needed)

Risks and Complications

• Minor discomfort during impression taking
• Possibility of infection or irritation of the surgical site
• Adjustments may be needed if the prosthesis does not fit perfectly
• Communication or swallowing difficulties if the prosthesis is not properly aligned

Benefits

• Restores function to the oral and maxillary regions
• Enhances speech and swallowing capabilities
• Improves aesthetic appearance
• Patients typically notice improved function within a few days to weeks after final fitting

Recovery

• Post-procedure care involves good oral hygiene and regular follow-ups.
• Patients may experience mild discomfort initially.
• Recovery time varies, but patients generally adapt to the prosthesis within a few weeks.
• Follow-up appointments to fine-tune the fit and function of the prosthesis.

Alternatives

• Non-surgical prosthetic options
• Surgical reconstruction of the maxillary defect
• Each alternative has its pros and cons, such as differences in recovery time, invasiveness, and overall effectiveness.

Patient Experience

• During the procedure, patients may feel slight pressure or discomfort during the impression taking.
• After the procedure, mild soreness or irritation may be managed with over-the-counter pain relief.
• Patients may need time to adapt to speaking and eating with the new prosthesis.
• Continuous follow-up ensures optimal comfort and function, and adjustments can be made as needed.