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Case presentation : A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient [2]

Case presentation : A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient [2]

author: Amit Dattani, David Richardson, Chris J Butterworth | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Four weeks later, the patient was returned to the operating room for removal and modification of the obturator. The cavity was healing well, and both implants were firm with no evidence of infection. The initial obturator was modified with the application of a soft lining material and the patient subsequently discharged with instructions on the insertion and removal of the obturator.

At the 12-week review (Fig. 4), it was noted the patient had a degree of mucosal polypoidosis in the antral cavity, most probably plaque induced, where the patient found it difficult to clean around the implants. Oral hygiene instruction was reiterated, and construction of the definitive implant bar-retained obturator was commenced.

Four months following surgery (April 2014), a definitive implant bar-retained maxillary obturator was fitted utilising precision attachments (Rhein attachments, Rhein83, NY, USA.) (Figs. 5 and 6). The retention and support given by the obturator was excellent, and the patient and parents were very pleased with the aesthetic and functional outcome (Figs. 7, 8, 9 and 10) provided by this prosthetic rehabilitation. The patient was put on a regular maintenance programme of review at 6-month intervals and continued to display an excellent standard of oral hygiene around the implants and to report a high degree of oral functioning using it. All mucosal polyposis resolved very quickly following the patient’s improved hygiene measures. He continued under review with no evidence of recurrence or problems with the implants or prosthesis in the 22 months since the surgery. The plastic Rhein female attachments were replaced at 18 months, but no other modifications have been required to this obturator since it was fitted. A recent radiographic review (Fig. 11) demonstrated no significant peri-implant bone resorption, and clinically, there had been no alteration in facial growth or appearance (Fig. 12) of this young patient who was 16 years of age at the time of his final review (February 2017). He continues under regular review.

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