A Direct Investment Method of Closed Two-Piece Hollow Bulb Obturator

Maxillary defects occur due to surgical treatment of benign and malignant tumors, congenital malformation, and trauma. Prosthetic rehabilitation in such patients is influenced by the size and location of the defect. The most common of all intraoral defects are seen in the maxilla, in the form of an opening into the maxillary sinus and nasopharynx. These defects create disabilities in speech, deglutition, and mastication. The prosthesis which closes such an opening and recreates the functional separation of the oral cavity and sinus and nasal cavities is referred to as an obturator. Numerous techniques of hollow bulb fabrication have been mentioned in the literature from time to time. But there are only a few methods for bulb fabrication in two-piece obturator. This technique describes a direct investment method of waxed-up closed hollow bulb two-piece obturator. 1. Introduction Maxillofacial prosthetics is the branch of prosthodontics concerned with the restoration and/or replacement of the stomatognathic and craniofacial structures with prostheses that may or may not be removed on a regular or elective basis [1]. The most common of all intraoral defects are seen in the maxilla, and it may include hard and soft palate, maxillary sinus, floor of the nasal cavity, and the alveolar ridges [2]. These defects may occur due to surgical resection of benign and malignant tumors, congenital malformation, and trauma [3]. Maxillary intraoral defects due to surgical resection create an open link between the oral and nasal cavities causing difficulty in deglutition, speech, and an unaesthetic appearance. It also results in psychological trauma to the patient [4]. The goals of prosthetic rehabilitation for such patients are to fabricate obturators which separate the nasal and oral cavity and improve deglutition, speech, mastication, and esthetics [2, 3]. An obturator (Latin: obturare, to stop up) is a disc or plate, natural or artificial, which closes an opening or defect of the maxilla as a result of a cleft palate or partial or total removal of the maxilla for a tumor mass [5]. There are numerous techniques described in the literature for the fabrication of open and closed hollow obturators [6–14]. Most of these techniques have their own limitations, such as multiple processing steps while fabrication [15, 16]. All these types of obturators reduce the weight of the prosthesis while properly extending into the defect. Open hollow obturators tend to accumulate nasal secretions leading to odour and added weight [4, 17, 18]. Hence, these require frequent cleaning.