Interim obturation of palatal perforations to facilitate routine dental care.

Routine preventive or restorative dental procedures (or both) may be compromised, deferred, or even denied to patients with exceptional problems that complicate treatment. Perforations of the hard palate require temporary obturation while the patient receives routine dental care such as prophylaxis, periodontic treatment, restorative dentistry, and repair or modification of an existing prosthesis. Temporary obturation, using an adhesive peristomal covering has been a helpful adjunct to prevent the dehydrating of a patient's nasal tissues, to facilitate the patient's speech and deglutition, and to maintain the patient's psychological well-being while the prosthesis is out of the mouth. An effective, comfortable, and economical method of interim obturation has been described.

Palatal neoplasms: reconstruction considerations.

Review of the literature and our personal experience with carcinoma of the palate indicates that a significant number of patients may benefit from palatal resection, either as an initial modality, in a planned combined treatment program, or for salvage after radiation therapy. Under any of these circumstances an integral part of the treatment program is rehabilitation of speech and swallowing function through prosthetic repair. Familiarity with the potentials and techniques of prosthetic rehabilitation after palatal resection is an important concern for the head and neck oncologist.

Results of the Widmaier-Perko palatoplasty in clefts of secondary palate.

The Widmaier-Perko palatoplasty was evaluated in post alveolar clefts. The speech results of 42 Chinese patients revealed 78.5% as having acceptable speech. In post alveolar clefts of the soft palate only 80% had acceptable speech compared to 76% acceptable speech for clefts of the soft and hard palate. This compared favourably with other similar reported studies. No dental occlusal or growth disturbances were noted. There was significant middle ear disease in the patients examined. This type of palatoplasty does not disturb the palatine bone periosteum and may be helpful in preventing growth disturbances.

Dental management of head and neck cancer patients.

In the management of head and neck cancer, dentistry has an important supportive role. Many anatomical and functional changes caused by surgery for the removal of intraoral tumors can be corrected or improved upon by prosthetic dentistry. The control of dental pathology contributes to the immediate and long-term success of tumor treatment and facilitates rehabilitation. Radiotherapy and loss of teeth do not go hand in hand. Many oral complications associated with radiotherapy can now be avoided or controlled with early preventive and restorative measures. Patients receiving systemic chemotherapy often develop oral complications that require particular attention by the primary physician and the dentist. Control of dental pathology is important in patients receiving chemotherapy because of reduced immune mechanism and increased bleeding tendencies.

Oral rehabilitation by prosthetic restoration after maxillectomy for malignant tumors.

In maxillectomy patients, speech intelligibility between before and after insertion of prostheses has been reviewed by many investigators. Speech intelligibility was not related to the size of the defect, but rather to the defect region. Speech intelligibility was considerably improved by the use of prostheses. A great difference could not be found in escape rate from the nasal cavity between before and after insertion of prostheses, but there was a remarkable change in the spirometer. Postmaxillectomy functions are also easily restored by prosthetic oral rehabilitation, necessary to aid surgical procedure.

A two-part obturator prosthesis for use following maxillectomy in edentulous patients.

Some problems of conventional prostheses after maxillectomy are discussed. A two-part appliance which incorporates a removable, flexible obturator is described. It is simple to construct and comfortable to wear.