Fig. 12. Facial photograph views at 22-month follow-up
Fig. 12. Facial photograph views at 22-month follow-up
Fig. 11. Facial radiograph at 22-month follow-up
Fig. 11. Facial radiograph at 22-month follow-up
Fig. 10. Full facial view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 10. Full facial view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 9. Palatal view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 9. Palatal view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 8. Anterior view of definitive obturator prosthesis in occlusion
Fig. 8. Anterior view of definitive obturator prosthesis in occlusion
Fig. 7. Smile view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 7. Smile view of definitive implant-retained obturator at initial fitting (April 2014)
Fig. 6. Intaglio surface of definitive acrylic obturator with bar attachments in place. Note the absence of any other retaining clasps and the simple nature of this prosthesis
Fig. 6. Intaglio surface of definitive acrylic obturator with bar attachments in place. Note the absence of any other retaining clasps and the simple nature of this prosthesis
Fig. 5. Zygomatic implant bar utilising Rhein attachments for retention
Fig. 5. Zygomatic implant bar utilising Rhein attachments for retention
Fig. 4. Twelve-week review post-surgery prior to definitive impressions for the implant-supported prosthesis
Fig. 4. Twelve-week review post-surgery prior to definitive impressions for the implant-supported prosthesis
Fig. 3. Low-level right-sided maxillectomy with the insertion of two zygomatic oncology implants at time of surgery
Fig. 3. Low-level right-sided maxillectomy with the insertion of two zygomatic oncology implants at time of surgery
Fig. 2. Palatal swelling (post-biopsy) between upper right first and second premolar teeth
Fig. 2. Palatal swelling (post-biopsy) between upper right first and second premolar teeth
Fig. 1. Zygomatic oncology implant with cleansable polished surface for intra-oral component
Fig. 1. Zygomatic oncology implant with cleansable polished surface for intra-oral component
Dattani, A., Richardson, D. & Butterworth, C.J. A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient. Int J Implant Dent 3, 9 (2017). https://doi.org/10.1186/s40729-017-0073-7
Download citation
Received: 24 November 2016
Accepted: 26 February 2017
Published: 28 March 2017
DOI: https://doi.org/10.1186/s40729-017-0073-7
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Oral and Maxillofacial Surgery, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK
Amit Dattani
Maxillofacial Surgery, Regional Craniofacial Unit, Alder Hey Children’s Hospital, Liverpool, UK
David Richardson
Maxillofacial Prosthodontics, Regional Maxillofacial Unit, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK
Chris J. Butterworth
You can also sea...
Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol. 2010;11(10):1001–8.
Breeze J, Rennie A, Morrison A, Dawson D, Tipper J, Rehman K, et al. Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction. Br J Oral Maxillofac Surg. 2016;54(8):857–62.
Kim SM, Park MW, Cho YA, Myoung H, Lee...
The use of zygomatic implants to supplement the stability and retention of the maxillary obturator in this case has improved the function of the prosthesis and provided for a very high-quality rehabilitation for the patient reported with no evidence of disruption to facial growth in the 22 months following surgery.
The use of modified zygomatic implants (Fig. 1) allows improved hygiene by the patient of the implants within the maxillary defect. The threaded portion of the implants is fully engaged into the bone with only the smooth portion protruding into the defect. Clearly this ongoing hygiene by the patient is of utmost importance in preventing peri-implant soft and hard tissue changes, but the implant d...
The difficulty of restoration with a maxillary obturator prosthesis depends on the extent of the surgical resection, with the acceptance that resections with an increasing horizontal component provide a much greater prosthodontic challenge. The number of remaining teeth is a key component in conventional obturator design [9] with the remaining dentition being used exclusively to retain the prosthe...
The paediatric population rarely suffer malignant disease of the oral cavity requiring any form of maxillectomy, and there is little published evidence around the rehabilitation and restorative management of children undergoing such procedures. The seemingly most common approach for a limited low-level maxillary resection in a child would be to consider resection and simple prosthetic obturation a...
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-we...
A medically fit and well 13-year 11-month-old male was referred to the oral and maxillofacial surgery department at Alder Hey Children’s Hospital in Liverpool in regard to an intra-oral swelling of the right palatal region (Fig. 2). An incisional biopsy was initially reported as a pleomorphic adenoma of the premolar region. Subsequently, a CT scan showed no significant bony abnormality, and a w...
The characteristics of a good obturator will improve swallowing, speech function, minimise nasal fluid leakage from the antrum and nasal spaces, restore facial aesthetics including the teeth and facilitate masticatory function and speech. A surgical obturator can be provided at the time of surgery to facilitate function and haemostasis in the immediate post-operative period, and this can subsequen...
Maxillary defects of acquired [1] or congenital origin produce a communication between the oral and nasal cavities sometimes via an opening into the maxillary antrum and by direct communication into the nose. This in turn can result in masticatory compromise, swallowing and speech impairment, nasal fluid regurgitation and aesthetic concerns. The management of the maxillectomy patient is a complex ...
This report details the use of zygomatic oncology osseointegrated implants to support and retain a maxillary obturator in a 13-year-old male patient who underwent a right-sided hemi-maxillectomy (Brown Class 2b) (Brown and Shaw, Lancet Oncol 11:1001–8, 2010) for a myxoid spindle cell carcinoma. At the time of maxillary resection, two zygomatic oncology implants were inserted into the right zygom...
Dattani, A., Richardson, D. & Butterworth, C.J. A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient.
Int J Implant Dent 3, 9 (2017). https://doi.org/10.1186/s40729-017-0073-7
Download citation
Received: 24 November 2016
Accepted: 26 February 2017
Published: 28 March 2017
DOI: https://doi.org/10.1186/s40729-017-00...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Oral and Maxillofacial Surgery, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK
Amit Dattani
Maxillofacial Surgery, Regional Craniofacial Unit, Alder Hey Children’s Hospital, Liverpool, UK
David Richardson
Maxillofacial Prosthodontics, Regional Maxillofacial Unit, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK
Chris J. Butterworth
You can also sea...
Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol. 2010;11(10):1001–8.
Breeze J, Rennie A, Morrison A, Dawson D, Tipper J, Rehman K, et al. Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction. Br J Oral Maxillofac Surg. 2016;54(8):857–62.
Kim SM, Park MW, Cho YA, Myoung H, Lee...
The use of zygomatic implants to supplement the stability and retention of the maxillary obturator in this case has improved the function of the prosthesis and provided for a very high-quality rehabilitation for the patient reported with no evidence of disruption to facial growth in the 22 months following surgery.
The use of modified zygomatic implants (Fig. 1) allows improved hygiene by the patient of the implants within the maxillary defect. The threaded portion of the implants is fully engaged into the bone with only the smooth portion protruding into the defect. Clearly this ongoing hygiene by the patient is of utmost importance in preventing peri-implant soft and hard tissue changes, but the implant d...
The difficulty of restoration with a maxillary obturator prosthesis depends on the extent of the surgical resection, with the acceptance that resections with an increasing horizontal component provide a much greater prosthodontic challenge. The number of remaining teeth is a key component in conventional obturator design [9] with the remaining dentition being used exclusively to retain the prosthe...
The paediatric population rarely suffer malignant disease of the oral cavity requiring any form of maxillectomy, and there is little published evidence around the rehabilitation and restorative management of children undergoing such procedures. The seemingly most common approach for a limited low-level maxillary resection in a child would be to consider resection and simple prosthetic obturation a...
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-we...
A medically fit and well 13-year 11-month-old male was referred to the oral and maxillofacial surgery department at Alder Hey Children’s Hospital in Liverpool in regard to an intra-oral swelling of the right palatal region (Fig. 2). An incisional biopsy was initially reported as a pleomorphic adenoma of the premolar region. Subsequently, a CT scan showed no significant bony abnormality, and a w...
The characteristics of a good obturator will improve swallowing, speech function, minimise nasal fluid leakage from the antrum and nasal spaces, restore facial aesthetics including the teeth and facilitate masticatory function and speech. A surgical obturator can be provided at the time of surgery to facilitate function and haemostasis in the immediate post-operative period, and this can subsequen...
Maxillary defects of acquired [1] or congenital origin produce a communication between the oral and nasal cavities sometimes via an opening into the maxillary antrum and by direct communication into the nose. This in turn can result in masticatory compromise, swallowing and speech impairment, nasal fluid regurgitation and aesthetic concerns. The management of the maxillectomy patient is a complex ...
This report details the use of zygomatic oncology osseointegrated implants to support and retain a maxillary obturator in a 13-year-old male patient who underwent a right-sided hemi-maxillectomy (Brown Class 2b) (Brown and Shaw, Lancet Oncol 11:1001–8, 2010) for a myxoid spindle cell carcinoma. At the time of maxillary resection, two zygomatic oncology implants were inserted into the right zygom...