Name of the Procedure:

Impression and Custom Preparation; Palatal Lift Prosthesis

Summary

A procedure to create a custom-fitted device that helps lift the soft palate, improving speech and swallowing. It involves taking dental impressions and fabricating a specialized prosthesis.

Purpose

Addresses velopharyngeal insufficiency (VPI), a condition where the soft palate does not close properly, leading to speech problems and swallowing difficulties. The goal is to restore proper function for improved speech clarity and swallowing.

Indications

• Hypernasal speech due to VPI
• Trouble swallowing or frequent choking
• Conditions like cleft palate, neuromuscular disorders, or post-surgical deficits that affect palatal function
• Generally recommended for individuals who cannot achieve adequate soft palate closure through other means

Preparation

• Thorough dental and medical examination
• Diagnostic tests like speech analysis and nasoendoscopy
• Patients may need to avoid certain foods or medications before the procedure
• No special fasting normally required

Procedure Description

1. Initial Consultation: Assess the patient's needs and suitability.
2. Impression Taking: Dental impressions are made using a moldable material to capture the shape of the oral structures.
3. Prosthesis Fabrication: Impressions are sent to a lab where a custom palatal lift prosthesis is crafted.
4. Fitting Session: The prosthesis is adjusted and fitted to ensure comfort and effectiveness. Minor adjustments may be made.
5. Follow-Up Appointments: To monitor effectiveness and make further adjustments if needed.

Tools/Eequipment:

• Dental impression materials
• Prosthesis fabrication tools

Anesthesia:

• Usually not required, but local anesthesia may be used for comfort.

Duration

The initial impression-taking process takes about 30-60 minutes. Prosthesis fabrication may take 1-2 weeks. Fitting and adjustment sessions can vary from 1-2 hours.

Setting

• Dental office or specialized outpatient clinic

Personnel

• Dentist or prosthodontist
• Dental technicians

Risks and Complications

• Discomfort or pressure in the mouth
• Ulceration or soreness due to improper fit
• Prosthesis breakage or wear over time
• Allergic reaction to materials (rare)

Benefits

• Improved speech clarity and swallowing function
• Reduced hypernasality
• Enhanced quality of life
• Benefits usually realized immediately after fitting and adjustment

Recovery

• Minimal recovery time
• Patients can resume normal activities almost immediately
• Regular follow-up visits for adjustments and maintenance

Alternatives

• Speech therapy
• Surgical interventions like pharyngeal flap surgery
• Pros: Non-invasive nature of the prosthesis compared to surgery
• Cons: May not be suitable for all patients; requires maintenance

Patient Experience

Patients may feel mild discomfort during the impression process. The fitting and adjustment might take multiple visits for optimal comfort and functionality. Pain management usually not necessary, as the process is generally well-tolerated.