Impression Technique for a Patient with Maxillary Defect - A Case Report

Special tray was checked in patient’s mouth and the space between the tray and tissues was examined. Tray adhesive was applied to increase the adhesion between the tray and additional silicone and border molding was performed (Fig. 6).

Final Impressions

Spacer was removed and wash impression was performed except in defect area. Putty material was mixed and secured with gauge piece and placed in patient defect area and all head moment are recorded. After recording the defect area putty was attached to special tray (Fig. 7).

Master Casts

Master cast was poured using dental stone (Fig. 8).

After making the impression with the right technique, the sequential steps of complete denture construction were followed as usual. (Figure – 9).

Discussion

Prosthodontic management of palatal defects has been employed for many years. Ambroise Pare probably was the first to use artificial means to close a palatal defect - as early as the 1500's. The early obturators were used to close congenital rather than acquired defects. The early objectives of treatment were artificial closure of the defect and adequate retention of the artificial closure. The ingenious designs of the early pioneers accomplished these objectives. As time progressed, newer and better concepts of obturators evolved.

The basic objectives of prosthodontic therapy include a comfortable, cosmetically acceptable prosthesis that restores the impaired physiologic activities of speech, deglutition and mastication. The most important objective of prosthodontic care, as DeVan stated, our objective should be “The perpetual preservation of what remains rather than the meticulous restoration of what is missing.” This principle is most important in the treatment of the maxillary defect patient.

The discomfort caused by hard resin presents another problem. Popular maxillofacial prosthodontist, Dr. Albert has almost completely abandoned the use of rigid prosthetic materials for making obturators. Among the synthetized materials, he found silicon-rubber components to be the most effective. They are easy to produce and function well. However, for the permanent obturator, maxillofacial prosthodontist Brown states, “. . . heat-cured methyl methacrylate resin still remains the material of choice for tissue compatibility, environmental resistance and ease of adjustment.”

Summary

A thorough knowledge of what is normal is a must for the dentist to understand the acquired defects with which he interacts. It is important that the clinician become familiar with a technique and master it. It must always be remembered, and patient must be so counselled before treatment, that the clinician can only try to provide alternative means of what the patient has lost, and how successful that alternative will be, depends upon the patient’s ability to accept the defect and to adapt to an alternative environment.

“Not mere survival from disease alone, but a return to a normal functioning life” is a must.

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