The Fabrication of a Hollow Bulb Obturator for a Patient with a Hemi-Maxillectomy Defect By Sanchia Kemp In partial fulfillment of BTech: Dental Technology

Contents History Condition and Background Possible Clinical Treatment Options Possible Technical Treatment Options Treatment Option of Choice Laboratory Procedures Problem Areas

History 1 st Diagnosis 1987 Age 14 Tumor removed 2 nd Diagnosis October 2001 Age 28 Pain and discomfort

Condition and Background Osteosarcoma Young adults, children Reoccur 90% 1 Surgically removed Hemi-maxillectomy Intermediate obturator

Possible Clinical Treatment Options Free-fibula graft Bone transplant 2 (osteotomy) Zygomatic implants

Possible Technical Treatment Options Hollow bulb±R800 Metal framework±R1200 Zygomatic implants±R1000/hr

Treatment Options Most suitable option Hollow bulb with metal framework Option of choice Acrylic hollow bulb

Laboratory Procedures Primary impression Lab putty Special tray Final impression

Laboratory Procedures Plaster and pumice mixture Acrylic “cover plate” 3 Clasps and base plate

Laboratory Procedures Articulated Set-up and wax- up Try-in

Laboratory Procedures Plaster base Slots 4 Stone matrix

Laboratory Procedures Even layer self cure acrylic resin

Laboratory Procedures Ready for final placement Trimmed and polished

Problem Areas Model destroyed No desirable flask Peripheral seal Adjustments

Problem Areas Wax on inside Layer self-cure acrylic resin Trimmed and polished

Before

After

References 1) Fauci, A.S.& Longo, D.L. Harrison’s principles of internal medicine, 15 th ed. USA: McGraw-Hill. 2001: ) Holland, F.H.& Frei, E. Cancer medicine, 5 th ed. Canada: B.C. Decker Inc. 2000: ) Minsley, G.E. An alternative method for fabrication of a closed hollow obturator. JPD. 1986; 55: ) Palmer, B.& Coffey, K.W. Fabrication of the hollow bulb obturator. JPD. 1985; 53:

Acknowledgements 1. Dr van Zyl 2. Ms Nortjé 3. Mr Mazema 4. Mrs Wright