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PURPOSE: To evaluate the intramucosal retention system in patients' masticatory efficiency and quality of life in this case series. MATERIAL AND METHODS: A total of 3 individuals with maxillectomy were included for rehabilitation with a complete obturator prostheses with an intramucosal retention system (OPI). The complete obturator prostheses was made for 60 days, and electromyography assessments and bite force were applied before, after 30, 60, and 90 days of surgery and prostheses installation. The University of Washington Quality of Life Questionnaire (UW-QoL) and the Obturator Functional Scale (OFS) were also administered at baseline and in the same follow-up periods. The electromyography was evaluated on both sides of the masseter, temporalis, and buccinator muscles while chewing hard and soft food. The maximum bite force was recorded in the central incisors and both sides of the first molar region. RESULTS: Bite force values increased in the first molar region, and muscular electrical activity remained constant. Items related to the taste and swallowing of the UW-QOL impacted. Most OFS questionnaire data responses indicated that patients improved in swallowing liquid foods and appearance. CONCLUSIONS: The rehabilitative capacity improves masticatory efficiency and QoL in adults maxilectomized and rehabilitated with OPI analysis in the study. Further clinical studies should be encouraged to determine the effectiveness of this retentive system.

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Abstract Introduction: Individuals with cleft palate can present with velopharyngeal dysfunction after primary palatoplasty and require a secondary treatment due to insufficiency. In these cases, the pharyngeal bulb prosthesis can be used temporarily while awaiting secondary surgery. Objective: This study aimed to investigate the outcome of treatment of hypernasality with pharyngeal bulb prosthesis in patients with history of cleft palate presenting with velopharyngeal insufficiency after primary palatal surgery. We hypothesized that the use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency in patients with cleft palate. Methods: Thirty speakers of Brazilian Portuguese (15 males and 15 females) with operated cleft palate, ages ranging from 6 to 14 years (mean: 9 years; SD = 1.87 years), participated in the study. All patients were fitted with a pharyngeal bulb prosthesis to manage velopharyngeal insufficiency while they were awaiting corrective surgery to be scheduled. Auditory-perceptual analysis of speech recorded in the conditions with and without pharyngeal bulb prosthesis were obtained from three listeners who rated the presence or absence of hypernasality for this study. Results: Seventy percent of the patients eliminated hypernasality while employing the pharyngeal bulb prosthesis, while 30% still presented with hypernasality. The comparison was statistically significant (p < 0.001). Conclusion: The use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency.

Resumo Introdução: Indivíduos com fissura palatina podem apresentar disfunção velofaríngea após a palatoplastia primária e necessitam de um secundário devido à insuficiência velofaríngea. Nesses casos, o obturador faríngeo pode ser usado temporariamente enquanto se aguarda uma cirurgia secundária. Objetivo: Investigar o resultado do tratamento da hipernasalidade com o uso de obturador faríngeo em pacientes com histórico de fissura palatina que apresentam insuficiência velofaríngea após a palatoplastia primária. Nossa hipótese é que o uso do obturador faríngeo seja uma abordagem eficaz para eliminar a hipernasalidade relacionada à insuficiência velofaríngea em pacientes com fissura palatina Método: Participaram do estudo 30 indivíduos falantes do Português Brasileiro (15 homens e 15 mulheres) com fissura palatina operada, de 6 a 14 anos de idade (média: 9 anos; DP = 1,87 anos). Todos os pacientes receberam obturador faríngeo para o tratamento da insuficiência velofaríngea, enquanto aguardavam vaga para a cirurgia secundária. A análise perceptivo-auditiva da fala, realizada nas condições com e sem obturador faríngeo, foi realizada por três ouvintes, quanto à presença e ausência da hipernasalidade. Resultados: 70% dos pacientes eliminaram a hipernasalidade de fala com o uso do obturador faríngeo, enquanto 30% não eliminaram. A comparação foi estatisticamente significante (p < 0,001). Conclusão: O uso temporário do obturador faríngeo é uma abordagem efetiva para eliminar a hipernasalidade decorrente da insuficiência velofaríngea.

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INTRODUCTION: Individuals with cleft palate can present with velopharyngeal dysfunction after primary palatoplasty and require a secondary treatment due to insufficiency. In these cases, the pharyngeal bulb prosthesis can be used temporarily while awaiting secondary surgery. OBJECTIVE: This study aimed to investigate the outcome of treatment of hypernasality with pharyngeal bulb prosthesis in patients with history of cleft palate presenting with velopharyngeal insufficiency after primary palatal surgery. We hypothesized that the use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency in patients with cleft palate. METHODS: Thirty speakers of Brazilian Portuguese (15 males and 15 females) with operated cleft palate, ages ranging from 6 to 14 years (mean: 9 years; SD = 1.87 years), participated in the study. All patients were fitted with a pharyngeal bulb prosthesis to manage velopharyngeal insufficiency while they were awaiting corrective surgery to be scheduled. Auditory-perceptual analysis of speech recorded in the conditions with and without pharyngeal bulb prosthesis were obtained from three listeners who rated the presence or absence of hypernasality for this study. RESULTS: Seventy percent of the patients eliminated hypernasality while employing the pharyngeal bulb prosthesis, while 30% still presented with hypernasality. The comparison was statistically significant (p < 0.001). CONCLUSION: The use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency.

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Los procesos tumorales que comprometen la región de cabeza y cuello, pueden afectar particularmente la identidad del ser humano. Para la eliminación de estas neoplasias existen diferentes alternativas terapéuticas, que generan secuelas de tipo funcional, afectando: la fonación, deglución y masticación, además de defectos estéticos y alteraciones psicológicas. Por consiguiente, el enfoque para el tratamiento de pacientes con cáncer se basa no solamente en el control de la enfermedad, sino también en la supervivencia, rehabilitación y su reintegración a la sociedad. A continuación se presenta el caso de un paciente con defecto orofacial, resultado del tratamiento ante un carcinoma basocelular, con radioterapia y su posterior resección quirúrgica tras recidiva tumoral. Se rehabilita mediante la elaboración de una prótesis híbrida (obturador intraoral y prótesis facial) con el objetivo de compensar parcialmente las pérdidas funcionales, estéticas, incidiendo positivamente en su estado psicosocial.

Tumor processes compromising the head and neck region can particularly affect the identity of the human being. There are different therapeutic alternatives to remove these dysplasias, which generate functional sequels affecting phonation deglutition and mastication. Therefore, approach for cancer patients is not only based on control of the disease, but additionally in patient's survival, rehabilitation and reinsertion in society. We hereby present the case of a patient with an orofacial defect resulting from treatment of basal cell carcinoma with X-ray therapy and later surgical resection after tumor recurrence. The patient was rehabilitated with manufacture of a hybrid prosthesis (intraoral obturator and facial prosthesis) which was achieved with the purpose of partially compensating functional and aesthetic losses and thus improving the patient's psychosocial circumstances.

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O objetivo do presente artigo é relatar a abordagem odontológica com obturador palatino imediato diferenciado em um caso clínico de tumor neuroectodérmico melanótico da infância, ocorrido no Instituto Nacional de Câncer José Alencar Gomes da Silva, realizando uma revisão da literatura e abordando o atendimento multidisciplinar como garantia do cuidado integral ao paciente. Lactente, 4 meses, sexo masculino, tumoração em maxila esquerda, foi encaminhado à seção de Odontologia para confecção de obturador palatino com projeção maxilar. O paciente que é submetido a um tratamento mutilador na tentativa de cura de alguma neoplasia de cabeça e pescoço necessita de conforto, bem-estar e um cuidado integral da equipe multidisciplinar, sendo o cirurgião-dentista parte dessa equipe.

The aim of this paper is to report a dental strategy with a differentiated immediate palatal obturator in a case of melanotic neuroectodermal tumor of infancy, held at the National Cancer Institute José Alencar Gomes da Silva, by performing a literature review and addressing the multidisciplinary treatment as a guarantee of integral care for the patient. Infant, 4 months, male, tumor in the left maxilla, was referred to the Odontology section for a palatal obturator confection with maxillary projection. The patient who is submitted to a mutilating treatment in an attempt to cure any head and neck neoplasm needs comfort, wellness and integral care from the multidisciplinary team, being the dentist part of it.

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