Dr Prince Kumar (PROSTHODONTICS)

1. OBTURATORS
Dr Prince Kumar
DEPARTMENT OF PROSTHODONTICS

2. Obturators
Department Of Prosthodontics & Oral Implantology

3. • The most common of intra oral defects are
in the form of cleft or opening in the palate
• These defects may be acquired or
congenital :-
•Acquired –
due to injuries or surgical excision of tumor
•Congenital –
due to malformation.

4. • When definite restoration involving fixed
or removable prosthesis is needed to
replace missing teeth to stabilize and
align the arch segment, restore the
occlusal function, provide facial support
and helps in speech
• All this is usually aided with the help of
an OBTURATOR
• The name obturator is derived from the
Latin verb “obturare” which means close
or to shut off

8. • According to the glossary of prosthodontic
terms :-
Obturator – As prosthesis used to
close a congenital or an acquired tissue
opening, primarily of hard palate and or
contiguous alveolar structures
(GPT- 8th Edi.)

9. FUNCTIONS OF AN OBTURATOR:
• Used to keep the wound or defective area
clean, and it can enhance the healing of
traumatic or post surgical defects
• Help to re-shape or reconstruct the
defect
• Improves or in some instances makes
speech possible

10. • In important area of esthetics the
obturator can be used to correct lip
and cheek position
• It can benefit the morale of patients
with maxillary defects
• When deglutition and mastication are
impaired, it can be used to improve
functions

11. • Reduces the flow of exudates into the
mouth
• Can be used as a stent to hold dressing or
packs post surgically

12. CLASSIFICATION2,4
-by Mohamed A. Aramany(1978)
(Reprinted in 2001)

13. Class I
The resection in this group is performed along the
midline of the maxilla, the teeth are maintained on one
side of the arch. This is the most frequent maxillary
defect, and most patients fall into this category.

14. Class II
The defect in this group is unilateral, retaining the anterior
teeth on the contralateral side. The recommended design is
similar to the design of a Class II Kennedy removable partial
denture, in which indirect retention minimizes the possibility of
dislodgment of the prosthesis under gravity.
The central incisor and
sometimes all the anterior teeth to
the canine or premolar are saved.

15. Class III
The palatal defect occurs in the central portion of the
hard palate and may involve part of the soft palate. The surgery
does not involve the remaining teeth. The design for these
patients is simple, and retention, stabilization, and reciprocation
can be effectively planned.

16. Class IV
The defect crosses the midline and involves both sides
of the maxilla. There are few teeth remaining which lie in a
straight line, which may create a unique design problem similar
to the unilateral design of conventional removal partial
dentures.

17. Class V
The surgical defect in this situation in bilateral and lies
posterior to the remaining abutment teeth. Labial stabilization
may be needed, and splitting of remaining abutments is
advisable.

18. Class VI
It is rare to have an acquired maxillary defect anterior to
the remaining abutment teeth. This occurs mostly in trauma or
in congenital defects rather than as a planned surgical
intervention. In this class, cross arch stabilization is derived
through a system of cross arch bars which will provide wide
distribution of support and retention from separated abutment
teeth.

19. BASIC OBJECTIVES OF AN
OBTURATOR:
– It should be comfortable
– Should restore adequate speech, deglutition,
and mastication
– Should be acceptable cosmetically
To achieve all these objectives, the
obturator should have adequate support,
retention and stability

20. SUPPORT:
• Support gives the resistance to
movement of the prosthesis towards
the tissue
• Support is available from:
–Residual maxilla
–Within the defect

21. RETENTION
• Retention is the resistance to vertical
displacement of the prosthesis
• Retention is provided by:-
–Within the residual maxilla
–Within the defect

22. STABILITY
• Stability is the resistance to prosthesis
displacement by functional forces
• Stability is offered by:
– Residual Maxilla Stability
– Within the defect stability

23. • Prosthetic therapy for patients with
acquired surgical defects of maxilla can
be arbitrarily divided into 2 phases of
treatment:-
The initial phase called surgical
obturation which entails the placement of
prosthesis at surgery (temporary prostheses)
or immediately thereafter (transitional). The
objective of surgical obturation is to restore
and maintain oral function at reasonable
levels during the postoperative period until
healing is completed

24. Three to four months after surgery, the
surgical site becomes stable dimensionally
thus permitting construction of the
definitive prosthesis or the second
phase of prosthodontic therapy

25. Surgical Obturator:
• It is defined as a temporary prosthesis used
to restore the continuity of the hard palate
immediately after surgery or traumatic loss
of a portion or all of the hard palate or
Contiguous alveolar structure
• The obturator may be placed immediately
after surgery or seven to ten days post
surgically.

26. DEFINITIVE OBTURATION:
• Three to four months after surgery
consideration may be given to the
construction of the definitive obturator
prosthesis from post surgical maxillary cast
• The timings will vary depending on the size
of the defect, the prognosis of the healing,
prognosis of the tumor control, the
effectiveness of the present obturator and
the presence or absence of the teeth

27. WEIGHT REDUCTION
(HOLLOW OBTURATORS)
• Obturators should be hollow and light
weight, So that teeth and supporting
structures are not stressed unnecessarily
Advantages of a Hollow bulb obturator:
a. Weight of prosthesis is reduced, so it is
more comfortable and efficient
b. Changes one of the fundamental problems
of retention and increases physiologic
function

29. c. The decrease in pressure to the
surrounding tissues aids in deglutition
and encourages the regeneration of
tissue
d. Does not add to the self consciousness
of wearing a denture
e. Does not cause excessive atrophy and
physiologic changes in muscle balance