obturators / academy of fixed orthodontics

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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.

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<ul><li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Maxillofacial prostheticsMaxillofacial prosthetics is the art andis the art and science of anatomic, functional, orscience of anatomic, functional, or cosmetic reconstruction by means of noncosmetic reconstruction by means of non living substitutes of those regions in theliving substitutes of those regions in the maxilla, mandible, and face that aremaxilla, mandible, and face that are missing or defective because of surgicalmissing or defective because of surgical intervention, trauma, pathology, orintervention, trauma, pathology, or developmental or congenital malformation.developmental or congenital malformation. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Objectives of Maxillofacial Prosthetics: The most importantThe most important objectivesobjectives of maxillofacialof maxillofacial prosthetics and rehabilitation include:prosthetics and rehabilitation include: 1.1. RRestoration of esthetics or cosmetic appearanceestoration of esthetics or cosmetic appearance of the patient.of the patient. 2.2. RRestoration of function.estoration of function. 3.3. PProtection of tissues.rotection of tissues. 4.4. TTherapeutic or healing effect.herapeutic or healing effect. 5.5. PPsychologic therapy.sychologic therapy. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Types of Maxillofacial Deformities CONGENITALCONGENITAL Cleft palateCleft palate Cleft lipCleft lip Facial cleftFacial cleft Missing earMissing ear PrognathismPrognathism ACQUIREDACQUIRED AccidentsAccidents SurgerySurgery PathologyPathology DEVELOPMENTALDEVELOPMENTAL PrognathismPrognathism RetrognathismRetrognathism www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Probably the most common of allProbably the most common of all intraoralintraoral defects are in thedefects are in the maxillamaxilla, in the form of an, in the form of an openingopening into theinto the nasopharynxnasopharynx. The. The prosthesis needed to repair the defect isprosthesis needed to repair the defect is termed atermed a maxillary obturatormaxillary obturator.. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Obturators AnAn obturatorobturator ((LatinLatin:: obturareobturare,, to stop upto stop up) is a disc) is a disc or plate, natural or artificial, which closes anor plate, natural or artificial, which closes an opening.opening. A prosthesis used to close a congenital orA prosthesis used to close a congenital or acquired tissue opening, primarily of the hardacquired tissue opening, primarily of the hard palate and/or contiguous structures.-palate and/or contiguous structures.-GPT-8GPT-8 www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> DEFINITIVE OBTURATOR A prothesis that artificially replaces part or all of the maxilla and associated teeth lost due to surgery or trauma. INTERIM OBTURATOR A prosthesis that is made several weeks or months following the surgical resection of a portion of one or both maxillae. It frequently includes replacement of teeth in the defect area. SURGICAL OBTURATOR A temporary prosthesis used to restore the continuity of the hard palate immediately after surgery or traumatic loss of a portion or all of the hard palate and/or contiguous alveolar structures (gingival tissue, teeth) www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> The obturator fulfills manyThe obturator fulfills many functionsfunctions.. 1.1. It can serve in lieu of a Levin tube for feeding purposes.It can serve in lieu of a Levin tube for feeding purposes. 2.2. It can be used to keep the wound or defective area cleanIt can be used to keep the wound or defective area clean 3.3. It can enhance the healing of traumatic or postsurgicalIt can enhance the healing of traumatic or postsurgical defects.defects. 4.4. It can help to reshape and reconstruct the palatal contourIt can help to reshape and reconstruct the palatal contour and/or soft palate.and/or soft palate. 5.5. It also improves speech or, in some instances, makesIt also improves speech or, in some instances, makes speech possible.speech possible. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> 6.6. In the important area of esthetics, the obturator can beIn the important area of esthetics, the obturator can be used to correct lip and cheek position.used to correct lip and cheek position. 7.7. It can benefit the morale of patients with maxillaryIt can benefit the morale of patients with maxillary defects.defects. 8.8. When deglutition and mastication are impaired, it canWhen deglutition and mastication are impaired, it can be used to improve function.be used to improve function. 9.9. It reduces the flow of exudates into the mouth.It reduces the flow of exudates into the mouth. 10.10. The obturator can be used a a stent to hold dressingsThe obturator can be used a a stent to hold dressings or packs postsurgically in maxillary resections.or packs postsurgically in maxillary resections. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> TheThe Aramany classificationAramany classification system ofsystem of postsurgical maxillectomy defectspostsurgical maxillectomy defects is ais a useful tool for teaching and developinguseful tool for teaching and developing obturatorobturator framework designsframework designs andand enhancing communication amongenhancing communication among prosthodontists.prosthodontists. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> This article describes a series of Aramany-This article describes a series of Aramany- obturatorobturator design templatesdesign templates and discussesand discusses the relevant considerations for each. In allthe relevant considerations for each. In all situations, asituations, a quadrilateral or tripodalquadrilateral or tripodal designdesign is favored over ais favored over a linear designlinear design because this allows a more favorablebecause this allows a more favorable leverage design application that will aid inleverage design application that will aid in thethe supportsupport,, stabilizationstabilization, and, and retentionretention ofof the prosthesis.the prosthesis. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> IInn 19781978 the latethe late Dr.Mohammed AramanyDr.Mohammed Aramany presented the first published system ofpresented the first published system of classificationclassification ofof postsurgical maxillarypostsurgical maxillary defectsdefects.. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> He divided all defects intoHe divided all defects into 6 categories6 categories based on thebased on the relationship of the defect torelationship of the defect to the remaining teeth and the frequency ofthe remaining teeth and the frequency of occurrence of the defectoccurrence of the defect.. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Dr Aramany recognized that, in addition toDr Aramany recognized that, in addition to being communication tool, a classificationbeing communication tool, a classification that grouped particular combinations ofthat grouped particular combinations of teeth and surgical defects hadteeth and surgical defects had relevancerelevance to the eventual design of a maxillaryto the eventual design of a maxillary obturator prosthesis framework.obturator prosthesis framework. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> The classification could be used to developThe classification could be used to develop a series of basic obturator designsa series of basic obturator designs (templates) that have proven(templates) that have proven clinicallyclinically successfulsuccessful andand scientifically acceptable inscientifically acceptable in particular situationsparticular situations.. These templates could then be applied toThese templates could then be applied to other dental arches of similar classificationother dental arches of similar classification or logically modified when slightly differentor logically modified when slightly different situations presented.situations presented. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> He also recognized that although theHe also recognized that although the framework designs varied greatly withframework designs varied greatly with each group, the designeach group, the design objectives wereobjectives were always the samealways the same.. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Design andDesign and leverageleverage were to he used towere to he used to allocate, distribute, neutralize, or controlallocate, distribute, neutralize, or control the anticipated functional forces so thatthe anticipated functional forces so that each supporting, stabilizing, or retainingeach supporting, stabilizing, or retaining element of the oral cavity could be usedelement of the oral cavity could be used withwith maximum effectivenessmaximum effectiveness without beingwithout being stressed beyond its physiologic limits.stressed beyond its physiologic limits. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Preservation of the remaining teethPreservation of the remaining teeth, which, which is critical for support, stabilization, andis critical for support, stabilization, and retention of the prosthesis, is aretention of the prosthesis, is a primaryprimary goalgoal in all classes.in all classes. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> GENERAL COMMENTS The general principles of removable partialThe general principles of removable partial denture (RPD) design apply to obturatordenture (RPD) design apply to obturator prosthesis design as well.prosthesis design as well. RelevantRelevant among these are:among these are: (1) The need for a rigid(1) The need for a rigid major connectormajor connector (2)(2) Guide planesGuide planes and other components thatand other components that facilitate stability and bracingfacilitate stability and bracing www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> (3) A design that maximizes(3) A design that maximizes supportsupport (4) Rests that place supporting(4) Rests that place supporting forces along theforces along the long axislong axis of the abutment toothof the abutment tooth (5)(5) Direct retainersDirect retainers that are passive at rest andthat are passive at rest and provide adequate resistance to dislodgmentprovide adequate resistance to dislodgment without overloading the abutment teethwithout overloading the abutment teeth (6)(6) Control of the occlusal planeControl of the occlusal plane that opposes thethat opposes the defect, especially when it involves natural teeth.defect, especially when it involves natural teeth. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> In addition,In addition, many unique considerationsmany unique considerations involvedinvolved in the design are provided by thein the design are provided by the nature of thenature of the problem and the treatment requiredproblem and the treatment required.. Among these are:Among these are: (1) The(1) The location and sizelocation and size of the defect, especiallyof the defect, especially as it relates to the remaining teethas it relates to the remaining teeth (2) The importance of the(2) The importance of the abutment toothabutment tooth adjacentadjacent to the defect, which is critical to the support andto the defect, which is critical to the support and retention of the obturator prosthesisretention of the obturator prosthesis www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> (3) The usefulness of the(3) The usefulness of the lateral scar bandlateral scar band,, which flexes to allow insertion of thewhich flexes to allow insertion of the prosthesis but tends to resist itsprosthesis but tends to resist its displacementdisplacement (4) The use of the(4) The use of the surveyorsurveyor to examine theto examine the defect for the purpose of locating anddefect for the purpose of locating and preserving useful undercuts or eliminatingpreserving useful undercuts or eliminating undesirable undercuts.undesirable undercuts. www.indiandentalacademy.comwww.indiandentalacademy.com </li> <li> Forces that are important in designing an obturator prosthesis framework have been discussed by Aramany. Briefly, these are: Vertical downward forces, because of gravit...</li></ul>