RESUMEN
Soft and hard tissue defects resulting from resective surgeries for carcinomas located in the maxillary arches can cause functional, esthetic, and psychological damage. A removable obturator prosthesis offers several advantages, restoring oral functions and improving patients' quality of life. Technological advancements, such as the use of intraoral scanning and computer-aided design (CAD) and manufacturing, reduce laboratory working time, eliminate the risk of impression material aspiration, and address challenges related to whole tissue undercut impression. Here, we report the case of a partially edentulous female patient with a velo-palatal defect for whom a rigid maxillary obturator prosthesis was fabricated. Digital impressions were taken and the standard tessellation language files of the scans were sent to the laboratory. Using dental CAD software, the maxillary metallic framework was designed and manufactured using selective laser melting technology. The obturators and artificial teeth were conventionally processed, with acrylic resin used for the rigid obturators. The resulting obturator prosthesis made it possible to close the oro-nasal communication and to improve swallowing, speaking, and chewing.
Asunto(s)
Diseño Asistido por Computadora , Maxilar , Obturadores Palatinos , Humanos , Femenino , Maxilar/cirugía , Persona de Mediana Edad , Diseño de Prótesis DentalRESUMEN
The aim of this study was to define the relation between load distribution and the number of implants supporting mandibular implant-supported screw-retained complete prostheses (ISCP). It is a three-dimensional (3-D) finite element study. Three models were simulated. The first one represents a 4-implant supported prosthesis (4ISP), the second one is a 3-implant supported prosthesis (3ISP) and the third one is a 6-implant supported prosthesis (6ISP). The 6ISP model showed the best bone stress distribution among all models. Its maximum stress value was 63.3 MPa. The 4ISP (98.9 MPa) showed a better bone stress distribution than the 3ISP (122.9 MPa). A flexion of the prosthesis was more important for the 4ISP than 3ISP and then 6ISP model at 10 MPa. In the 4 ISP and the 3ISP models, the anterior implants were more solicited. However, the stress was evenly distributed on the 6 implants, in the 6ISP model. Concerning, the stress distribution in bone, the uppermost stress was found in the 3ISP, then the 4ISP and then the 6ISP model. The increase of implants number reduces the stress on the bone and prosthesis and implants. The use of 6 implants to support screw-retained complete prostheses showed a better biomechanical behavior.