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Abstract
Objectives
The aim of this study was to evaluate the accuracy of two different impression techniques through the assessment of the performance of the two definitive obturators fabricated by each technique.
Patients
A total of six partially edentulous patients with unilateral maxillary surgical defects were selected from those admitted at the Prosthodontic Department, Faculty of Dentistry, Alexandria University.
Methods
For every patient, two hollow bulb obturators were constructed, each using a different impression technique. Three patients started with the open face tray impression technique and the other three started with the altered cast impression technique. Each patient was given one obturator at a time and was instructed to use it for 2 months. All patients were subjected to the following: (a) a preprosthetic evaluation, (b) an evaluation 2 months after the insertion of the first obturator, and (c) an evaluation 2 months after the insertion of the second obturator. During each session, speech and swallowing were evaluated.
Results
Regarding the three formant frequencies of the vowel /a/, there was a statistically significant improvement only in F1 between the altered cast and the preprosthetic phase and between the altered cast and the open face impression techniques, whereas concerning vowel /e/, there was a statistically significant improvement in F2 in favor of the altered cast impression technique. The degree of nasality in the vowels and the plosives were significantly improved in the altered cast technique. However, there was no significant improvement in the nasality between the two techniques with regard to oral and nasal sentences. There was an observed improvement in the competence and the shape of the velopharyngeal valve with the obturator than without the obturator.
Conclusion
The altered cast technique caused statistical improvement in the nasality of vowels and plosives as compared with the open face impression technique. Both treatment modalities caused general improvement in the patient’s satisfaction and in swallowing with no statistically significant difference between them.
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Devlin H, Barker GR. Prosthetic rehabilitation of the edentulous patient requiring a partial maxillectomy. J Prosthet Dent 1992; 67: 223–227.
Curtis TA, Beumer J. Restoration of acquired hard palate defects. In: Beumer J, Curtis TA, Marunick MT, eds Maxillofacial rehabilitation: prosthodontic and surgical considerations. St Louis, MO: Ishiyaku EuroAmerica; 1996: p. 122–8.
Martin JW, King GE, Kramer DC, Rambach SC. Use of an interim obturator for definitive prosthesis fabrication. J Prosthet Dent 1984; 51: 527–528.
Srinivasan M, Padmanabhan TV. Rehabilitation of an acquired maxillary defect. J Indian Prosthet Society 2005; 5: 155–157.
Arcuri MR, Taylor TD. Clinical management of the dentate maxillectomy patient. In: Taylor TD ed. Clinical maxillofacial prosthetics. Chicago, IL: Quitessence; 2000: 116–118.
Chandra TS, Sholapurkar A, Joseph RM, Aparna IN, Pai KM. Prosthetic rehabilitation of a complete bilateral maxillectomy patient using a simple magnetically connected hollow obturator: a case report. J Contemp Dent Pract 2008; 9: 70–76.
Kotby MN, Bassiony S, El-Zomar M, Mohsen E, Standardization of an articulation test. Proceedings of the 9th Annual Ain Shams Medical Congress; 1986; Cairo, Egypt.
Anasane N, Chitnis D. Rehabilitation of a maxillectomy defect with definitive hollow bulb obturator: a case report. J Indian Dent Assoc 2010; 4: 429–431.
Oh WS, Roumanas E. Alternate technique for fabrication of a custom impression tray for definitive obturator construction. J Prosthet Dent 2006; 95: 473–475.
Zaki HS, Aramany MA. Open-face custom tray for edentulous obturator impression. J Prosthet Dent 1981; 45: 639–642.
Tripathi S, Chand P, et al. A noval approach of altered cast technique in bilateral partial maxillectomy patient with severly restricted mouth opening. ISRN Dentistry 2011; 5: 34–39.
Sumita YI, Ozawa S, Mukohyama H, Ueno T, Ohyama T, Taniguchi H. Digital acoustic analysis of five vowels in maxillectomy patients. J Oral Rehabil 2002; 29: 649–656.
Xing GF, Jiao T, Sun J, Jiang YL. Evaluation of the speech outcomes in patients with unilateral maxillary defect rehabilitated with maxillary obturator prosthesis. Shanghai Kou Qiang Yi Xue 2005; 14: 352–354.
Eckardt A, Teltzrow T, Schulze A, Hoppe M, Kuettner C. Nasalance in patients with maxillary defects — reconstruction versus obturation. J Craniomaxillofac Surg 2007; 35: 241–245.
Rieger J, Wolfaardt J, Seikaly H, Jha N. Speech outcomes in patients rehabilitated with maxillary obturator prostheses after maxillectomy: a prospective study. Int J Prosthodont 2002; 15: 139–144.
De Krom G. Consistency and reliability of voice quality ratings for different types of speech fragments. J Speech Hear Res 1994; 37: 985–1000.
De Carvalho-Teles V, Pegoraro-Krook MI, Lauris JR. Speech evaluation with and without palatal obturator in patients submitted to maxillectomy. J Appl Oral Sci 2006; 14: 421–426.
Aramany MA, Drane JB. Effect of nasal extension section on the voice quality of acquired cleft palate patients. J Prosthet Dent 1972; 27: 194–201.
Kipfmueller LJ, Lang BR. Presurgical maxillary prosthesis: an analysis of speech intelligibility. J Prosthet Dent 1972; 28: 620–625.
Runte C, Tawana D, et al. Spectral analysis of /s/ sound with changing angulation of the maxillary central incisors. Int J Prosthet Dent 2002; 15: 254–258.
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El-Maghraby, R.M., El-Didi, L.M., Al-Shimy, A.M. et al. The speech outcome of definitive obturators constructed using two different impression techniques. Egypt J Otolaryngol 32, 61–66 (2016). https://doi.org/10.4103/1012-5574.175862
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DOI: https://doi.org/10.4103/1012-5574.175862