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4/9/2014 Faculty of Dentistry Mahidol University Occlusion Unit
http://elearning.dt.mahidol.ac.th/departments/maxillofacial/intro_2.html 1/1
Classification of oral and facial defects can be devided into two major categories:
1. congenital defect: a patient usually is born with the defect condition.2. acquired defect: a patient usually received a defect condition due to cancer,accident, etc.
I. Intraoral defects and their rehabilitation:
A. CONGENITAL INTRAORAL DEFECTS Patients with cleft lip and/or cleft palates are considered congenital defects. Suchpatients are born with a gapping hole in the palate. This poses a problem forconsumption of food and water, which can get into the nasal cavity. To rectify suchanomalies, most patients early in life undergo surgical reconstruction. Surgery howeveris not a complete answer to such deformities. Some of the persistent problems, includespeech impediments (i.e. lack of understandable speech) and incomplete closure of thepalate, still remain. Children with such congenital defect usually have a delay in speechdevelopment even though their intellectual development is not hindered. Completerehabilitation for such patients involves series of interventions, which are both complexand protracted. To correct speech impediment we, along with the help of a speechpathologist, employ prosthesis called “speech aid prosthesis”.
A prosthetic palate to augment the soft palate to improve speech competency.
A speech bulb: similar to aremovable denture.
Imcomplete surgical reconstruction of the cleft palate with no teeth remained
The soft palate relacement with prosthesis,a speech bulb. The speech bulb can simplyfunction and by adding teeth to the bulb to
increase optimal mastication.
The speech pathologist trains the patient to speak properly. Another device, calledthe “speech bulb prosthesis” is to assist the incorrect position of soft palate followingsurgical intervention. In some cases, additional surgical interventions are warranted,however more surgery may also mean protracted rehabilitation. Thus, in someinstances, speech aid prosthesis can almost substitute the soft palate and correct theproblem in a more conventional manner. In addition, other than a correction of speechincompetence, speech bulb prosthesis will also close any remaining hole on the palate.Due to its design, these prostheses have a similar feature to a removable denture; apatient can remove it overnight but also has to take care of his/her oral health to avoidinfection.
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