MAKSİLLER SİNÜS MALİGN NEOPLAZMLI HASTANIN PROTETİK REHABİLİTASYONU: OLGU SUNUMU

Yıl 2019, Cilt: 29 Sayı: 2, 320 - 325, 22.03.2019

Hatice Özdemir Merve Köseoğlu

https://doi.org/10.17567/ataunidfd.544624

Öz

Benign ve malign neoplazmların, maksiller kistlerin, travmatik ve
konjenital malformasyonların cerrahi tedavisi maksiller defektlere neden
olmaktadır. Maksil- ler defektler, oronasal ve oroantral bağlantılara ve bu- nun
sonucunda yenilen besinlerin ve gıdaların burun- dan geri akışına ve hipernazal
konuşmaya neden ol- maktadır. Hastaların obtüratörlerle protetik rehabilitas- yonu
ile estetik, fonksiyonel, sosyal ve psikolojik prob- lemlerinin çözümü
amaçlanmaktadır. Defektin büyük- lüğü ve lokalizasyonu, mevcut yumuşak doku
under- cutları, destek dişlerin sayısı ve kemik desteği obtüra- törün dizaynını
etkilemektedir. Obtüratörün retansi- yonu ve stabilizasyonu oral fonksiyonları
geliştirmek- tedir. Bu vakada,
maksiller sinüs malign neoplazmı teşhisi konulmuş 17 yaşında bayan hasta
kliniğimize başvurmuştur. Maksiller anterior bölgenin rezeksiyonu, ilgili
dişlerin çekimi, radyoterapi uygulaması ardından nazogastrik sonda
yerleştirilmiştir. Radyoterapiden 1 ay sonra, hastanın radyoterapisti
beslenmenin oral yol- dan sağlanması için nazogastrik sondanın çıkarılması ve
hastanın protezle rehabilite edilmesini istemiştir. Metal alt yapılı obtüratör
protezin tutuculuğu konvansi- yonel obtüratör protezlerden daha fazla olduğu
için metal altyapılı geçici obtüratör protez uygulanmıştır. Kontrol
randevularında obtüratör protezlerde herhangi bir estetik ve fonksiyonel
problem görülmemiştir.

Anahtar Kelimeler: Maksiller
sinüs karsinomu, Maksiller Defekt, Obturatör, Hollow bulb, Protetik
Rehabilitasyon

PROSTHETIC REHABILITATION OF A PATIENT WITH MAXILLARY SINUS NEOPLASM: A
CASE REPORT

ABSTRACT

 

Surgical treatment of  benign or malignant neoplasms, maxillary cysts, traumatic and congenital malformations induce maxillary defects. Maxillary defects create oronasal and oroantral communications that lead to nasal regurgitation of food and liquids and hyper-nasal peech. Prosthodontic rehabilitation of patients with obturators aims to solve the patients' aesthetic, functional, social and psycholo- gical problems. Location and size of the defects, vailable soft tissue undercuts, the number and bone support of the remaining abutment teeth effect the design of obturators. Retention and stability of the obturators improve oral functions. In  this case the pa- tient was a 17 years old girl. She was diagnosed with maxillary sinus malignant neoplasm. After the resec- tion of maxillary anterior region,  extraction of several teethand undergoing radiotherapy, a nasogastric tube was placed. One month after radiotherapy, patient’s radiotherapist aimed to remove the nasogastric tube and help her with feeding so wanted us to rehabilitate the patient with a prosthetis. A temporary obturator prosthesis with metal framework was designed. Because the retention of obturator prosthesis with metal framework is better than conventional obturator prosthesis. At the recall visits obturator prosthesis hasn’t got any aesthetic or functional problems.

Key Words: Maxillary
sinus carcinoma, Maxillary defect, Obturator, Hollow bulb, Prosthetic
rehabilitation

Anahtar Kelimeler

Maksiller sinüs karsinomu, Maksiller Defekt, Obturatör, Hollow bulb

Kaynakça

• 1. Hanawa S, Kitaoka A, Koyama S, Sasaki K. Influence of Maxillary Obturator Prostheses on Facial Morphology in Patients with Unilateral Maxillary Defects. J Prosthet Dent 2015;113:62-70.
• 2. Devlin H, Barker GR. Prosthetic Rehabilitation of The Edentulous Patient Requiring a Partial Maxillectomy. J Prosthet Dent 1992;67:223-7.
• 3. Brown JS, Shaw RJ. Reconstruction of The Maxilla and Midface: Introducing a New Classification. Lancet Oncol 2010;11:1001-8.
• 4. Nguyen CT, Driscoll CF, Coletti DP. Reconstruction of a Maxillectomy Patient with an Osteocutaneous Flap and Implant-retained Fixed Dental Prosthesis: A Clinical Report. J Prosthet Dent 2011;105:292-5.
• 5. Sharma AB, Beumer J . Reconstruction of Maxillary Defects: The Case for Prosthetic Rehabilitation. J Oral Maxillofac Surg 2005;63:1770-3.
• 6. Marx RE. Reconstruction of Defects Caused by Bisphosphonate-induced Osteonecrosis of The Jaws. J Oral Maxillofac Surg 2009;67:107-19.
• 7. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B.American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-related Osteonecrosis of The Jaw 2014 update. J Oral Maxillofac Surg 2014;72:1938-56.
• 8. Eckhardt A, Telzrow T, Schulze A, Hoppe M, Kuettner C. Nasalance in Patients with Maxillary Defects: Reconstruction Versus Obturation. J Craniomaxillofac Surg 2007;35:241-5.
• 9. Rieger JM, Tang JA, Wolfaardt J, Harris J, Seikaly H. Comparison of Speech and Aesthetic Outcomes in Patients with Maxillary Reconstruction Versus Maxillary Obturators After Maxillectomy. J Otolaryngol Head Neck Surg 2011;40:40-7.
• 10. Irish J, Sandhu N, Simpson C,Wood R, Gilbert R, Gullane P, Brown D, Golstein D, Devins G, Barker E. Quality of Life in Patients with Maxillectomy Prostheses. Head Neck. 2009;31:813-21.
• 11. Kornblith AB, Zlotolow IM, Gooen J, Huryn JM, Lerner T, Strong EW, Shah JP, Spiro RH, Holland JC. Quality of Life of Maxillectomy Patients Using an Obturator Prosthesis. Head Neck 1996;18:323-34
• 12. Aramany MA. Basic Principles of Obturator Design for Partially Edentulous Patients. Part I: Classification.J Prosthet Dent 2001;86:559-61.
• 13. Ono T, Kohda H, Hori K, Nokubi T. Masticatory Performance in Postmaxillectomy Patients with Edentulous Maxillae Fitted with Obturator Prostheses.Int J Prosthodont 2007;20:145-50.
• 14. Keyf F. Obturator Prostheses for Hemimaxillectomy Patients. J Oral Rehabilitation 2001;28:821-9.
• 15. Roumanas ED, Nishimura RD, Davis BK, Beumer J III. Clinical Evaluation of Implants Retaining Edentulous Maxillary Obturator Prostheses. J Prosthet Dent 1997;77:184-90
• 16. Yip JK, Borrell LN, Cho SC, Francisco H, Tarnow DP. Association Between Oral Bisphosphonate Use and Dental Implant Failure Among Middle-aged Women. J Clin Periodontol 2012;39:408-14.
• 17. Chigurupati R, Aloor N, Salas R, Schmidt BL. Quality of Life After Maxillectomy and Prosthetic Obturator Rehabilitation. J Oral Maxillofac Surg 2013;71:1471-8.
• 18. Beumer J, Curtis TA, Marunick MT. Maxillofacial Rehabilitation: Prosthodontic and Surgical Considerations. St. Louis; Ishiyaku Euro America: 1996. P. 225–84.
• 19. Winkler S. Essentials of Complete Denture Prosthodontics. St. Louis; Ishiyaku Euroamerica: 2004. p. 403-16.
• 20. Wu YL, Schaaf NG: Comparison of Weight Reduction in Different Designs of Solid and Hollow Obturator Prostheses. J Prosthet Dent 1989;62:214-7.
• 21. Brown KE. Clinical Considerations Improving Obturator Treatment. J Prosthet Dent 1970; 24:461-6.
• 22. Desjardins RP: Obturator Prosthesis Design for Acquired Maxillary Defects. J Prosthet Dent 1978;39:424-35.
• 23. McAndrew KS, Rothenberger S, Minsley GE: An Innovative Investment Method for The Fabrication of A Closed Hollow Obturator Prosthesis. J Prosthet Dent 1998;80:129-32.
• 24. Phankosol P, Martin JW: Hollow Obturator with Removable Lid. J Prosthet Dent 1985;54:98-100.
• 25. Benington IC, Lappin C, Linden GJ. The Clinical Success and Periodontal Evaluation of Patients Rehabilitated with Light-cured Obturators. J Oral Rehabil 1996;23:135-8.
• 26. Kocacikli M, Yalug S, Yazicioglu H, Yilmaz C. Fabricating a Hollow Obturator with Visible Light-cured Resin System. J Prosthodont 2008;17:596-8.
• 27. Taicher S, Rosen AG, Arbree NS, Bergen SF, Levy M, Lepley JB. A Technique for Fabrication of Polydimethylsiloxane-acrylic Resin Obturators. J Prosthet Dent 1983;50:65-8.
• 28. Glossary of Prosthodontic Terms. J Prosthet Dent 2005;94:10-92.
• 29. Nidiffer TJ, Shipmon TH. The Hollow Bulb Obturator for Acquired Palatal Openings. J Prosthet Dent 1957;7:126-34.
• 30. Brown KE. Clinical Considerations Improving Obturator Treatment. J Prosthet Dent 1970;24: 461-6.
• 31. Parel SM, Drane JB. Prosthetic Support of The Visual Apparatus Following Maxillectomy and Orbital Floor Resection. J Prosthet Dent 1975;34: 329-33.
• 32. Beumer J, Curtis TA, Firtell DN. Maxillofacial Rehabilitation: Prosthodontic and Surgical Considerations. St Louis; CV Mosby: 1996. p. 188–243.
• 33. Shimodaira K, Yoshida H, Yusa H, Kanazawa T. Palatal Augmentation Prosthesis with Alternative Palatal Vaults for Speech and Swallowing: A Clinical Report. J Prosthet Dent 1998;80:1–3.
• 34. Aramany MA. Basic Principles of Obturator Design for Partially Edentulous Patients. Part II: Design Principles. J Prosthet Dent 1978;40:554-7.
• 35. Fischman B. The Use of Light-cured Material for Immediate Hollow Obturator Prosthesis. J Prosthet Dent 1989;61:215-6.
• 36. Paprocki GJ, Jacob RF, Kramer DC. Seal Integrity of Hollow Bulb Obturators. Int J Prosthodont 1990;3:457-62.
• 37. Riley C. Maxillofacial Prosthetic Rehabilitation of Postoperative Cancer Patients. J Prosthet Dent 1968;20:352-60.
• 38. Shimodaira K, Yoshida H, Mizukami M ,Funakubo T. Obturator Prosthesis Conforming to Movement of The Soft Palate: A Clinical Report. J Prosthet Dent 1994;71:547-51.
• 39. Özdemir H, Aladağ Lİ. Sonradan Kazanılmış Bir Maksiller Defektin Protetik Obturasyonu: Bir olgu sunumu. Atatürk Üniv Diş Hek Fak Derg 2011;4:122-7.
• 40. Bal BT, Yavuzyılmaz H. Yumuşak Astar Maddeleri. Atatürk Üniv Diş Hek Fak Derg 2006;1:53- 60.
• 41. Zarb GA. The Maxillary Resection and Its Prosthetic replacement. J Prosthet Dent 1967;18:268-81.