1. 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

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

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

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

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

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

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

8. Laboratory Procedures Primary impression Lab putty Special tray Final impression

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

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

11. Laboratory Procedures Plaster base Slots 4 Stone matrix

12. Laboratory Procedures Even layer self cure acrylic resin

13. Laboratory Procedures Ready for final placement Trimmed and polished

14. Problem Areas Model destroyed No desirable flask Peripheral seal Adjustments

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

16. Before

17. After

18. References 1) Fauci, A.S.& Longo, D.L. Harrison’s principles of internal medicine, 15 th ed. USA: McGraw-Hill. 2001: 627-628. 2) Holland, F.H.& Frei, E. Cancer medicine, 5 th ed. Canada: B.C. Decker Inc. 2000: 1875-1877. 3) Minsley, G.E. An alternative method for fabrication of a closed hollow obturator. JPD. 1986; 55: 485-489. 4) Palmer, B.& Coffey, K.W. Fabrication of the hollow bulb obturator. JPD. 1985; 53:595-597.

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