What is the prosthodontic management in a patient who has undergone hemimaxillectomy?

Answer 1

There are two different approaches associated with this type of resection. A Prosthodontist or Maxillofacial Prosthodontist can fabricate a removable prosthesis that replaces missing teeth, hard and soft palate and serves to close off the communication to the sinus area and nasal cavity. This prosthesis is called an Obturator. It is stabilized by the remaining palate and teeth. It enables the patient to be able to speak and eat normally. Another possible treatment is a more surgical approach where an autologous bone graft is obtained from another area of the body like the leg (fibula), hip (iliac crest), or scapula and it is used to replace the defect area. The placement of dental implants into this harvested bone is also needed in order to support fixed crowns. It is possible to wear removable prosthetics on top of this graft, however the graft needs to be done in a way that restores pre-surgical soft tissue contour, otherwise it may be difficult for the patient to wear any prosthesis that provides chewing capabilities, esthetics and phonetics. Not all patients qualify for the surgical approach for a variety of reasons.