Prosthetic rehabilitation of soft palate resection edentulous patient with maxillary obturator

Seung-Beom Ryu; Seong-Joo Heo; Jai-Young Koak; Seong-Kyun Kim

doi:10.4047/jkap.2019.57.4.475

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Ryu, Heo, Koak, and Kim: Prosthetic rehabilitation of soft palate resection edentulous patient with maxillary obturator

Case Report

The Journal of Korean Academy of Prosthodontics 2019; 57(4): 475-482.

Published online: 25 October 2019

DOI: https://doi.org/10.4047/jkap.2019.57.4.475

Prosthetic rehabilitation of soft palate resection edentulous patient with maxillary obturator

Seung-Beom Ryu

, Seong-Joo Heo

, Jai-Young Koak

, Seong-Kyun Kim

Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea.

Corresponding Author: Seong-Joo Heo. Department of Prosthodontics, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. +82 (0)2 2072 2661: 0504heo@hanmail.net

Received 17 July 2019 Revised 21 August 2019 Accepted 8 September 2019

The Korean Academy of Prosthodontics

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This report is a case of 76-year old male patient who had difficulty in swallowing, pronunciation and suffered regurgitation of food. The patient lacks uvula and both tonsils, had short palatoglossal arch and soft palate, as well as defective left palatopharyngeal arch. The height and width of the soft palate defect were measured by reconstructing the Computed Tomography (CT) image in three dimensions. Phonation and soft palate obstructing ability were examined by nasometry and nasal endoscopy. Evaluations on phonetics and swallowing were done and improvements were shown. The patient was satisfied with the results of treatment.

Keywords: Palatopharyngeal insufficiency, Soft palate defect, Obturator, Edentulous jaw

Figures and Tables

Fig. 1

Initial photographs. (A) Maxillary occlusal view, (B) Mandibular occlusal view, (C) Panoramic radiograph, (D) Frontal view on right side, (E) Frontal view, (F) Frontal view on left side, (G, H) There is defect on soft palate and pharyngeal portion.

Fig. 2

Preliminary impression. (A) Tray and utility wax, (B) Impression using alginate, (C) Preliminary cast.

Fig. 3

(A) Impression for Master cast, (B) Master cast.

Fig. 4

Temporary denture. (A) Lateral view, (B) occlusal view, (C) Rear view, (D) Intraoral photo after delivery.

Fig. 5

(A) CT sagittal view, (B) CT horizontal view, (C, D) Reconstructing defect area image using Seg 3D.

Fig. 6

(A) Functional impression for obturator area, (B) Impression for definitive obturator.

Fig. 7

Metal framework. (A) Upper framework including velar and pharyngeal part, (B) Intraoral try-in.

Fig. 8

Definitive prosthesis. (A) Lateral view, (B) Rear view, (C) External oral photo, (D) Frontal view on right side, (E) Frontal view, (F) Frontal view on left side, (G) velar and pharyngeal area, (H) Frontal view on velar and pharyngeal area.

Fig. 9

T-scan result. (A) Centric occlusal, (B) Right and Left lateral excursion.

Fig. 10

Nasometry chart.

Fig. 11

Nasal endoscope image. (A) Rest state, (B) Closed state on pharyngeal area.

References

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ORCID iDs

Seung-Beom Ryu
https://orcid.org/0000-0003-0991-4792

Seong-Joo Heo
https://orcid.org/0000-0003-0699-4141

Jai-Young Koak
https://orcid.org/0000-0002-0190-0778

Seong-Kyun Kim
https://orcid.org/0000-0001-8694-8385

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