This document summarizes three case studies involving maxillofacial prosthetics: Case 1 describes a patient who underwent surgery for a fungal infection, leaving a maxillary defect that was rehabilitated with a magnet-retained facial prosthesis combined with a maxillary obturator. Case 2 involves a patient who underwent a maxillectomy for cancer treatment. His existing obturator prosthesis was failing, so precision ball attachments were added to enhance retention. Case 3 presents a patient with congenital palatal and bilateral cleft lip defects. A hybrid prosthesis was fabricated with a hollow bulb obturator and a labial extension to rehabilitate the defects.

1. CASE 1-Magnet-Retained Facial Prosthesis
Combined with Maxillary Obturator
• A 65 year old diabetic patient, with chief complain of
poor facial appearance and past history of diabetes
mellitus.His facial tissues were affected by a fungal
infection of rhinocerebral mucormycosis followed by
diabetic ketoacidosis. For debridement and removal of
necrotic tissues, ablative surgery was performed leaving
behind a maxillary defect and communication between
the oral,nasal and orbital cavity.

2. Fig: Midfacial defect
after surgery.
Fig 2: Intraoral view of the
Maxillary defect

3. • After precise evaluation of the case, the proposed
treatment plan was to construct a complete denture with
obturator, as well as a facial prosthesis which would be
attached to the obturator with cobalt samarium magnets
(Jobmasters, Randallstown, USA).

4. Fig: Master cast
In dental stone.
Fig 4: Wax try-in with ocular
Prosthesis.

5. Fig 5: Hollow acrylic
Substructure .
MDX4-4210-base silicone
with laminar intrinsic stain.
MAGNETS
Fig 6: attached intra and
extraoral prosthesis

6. Initial appearance Fig 7: completed prosthesis

7. CASE 2-Enhanced retention of a maxillofacial
prosthetic obturator using precision attachments
• A 65-year-old man was referred by his head and neck
surgeon to the Department of Prosthodontics at the
Ankara University, Faculty of Dentistry in Ankara, Turkey
major complaints were lack of retention and instability of
the prosthesis, impaired speech and mastication, and
liquid leakage into the oral cavity. Five years earlier, the
patient had been diagnosed with epidermoid carcinoma
of the maxillary sinus that was treated by a unilateral
maxillectomy followed by post-surgical radiation therapy.
After 4 years of successful treatment with a conventional
obturator prosthesis, he presented with an ill-fitting
obturator that was no longer retentive

8. • Extra-oral examination - Collapsed midface and diplopia.
• Intra-oral examination - Resectioning of the hard palate,
alveolar bone, teeth and soft tissue that did not exceed the
midline. The patient had 4 viable maxillary teeth (left central
incisor, left lateral incisor, left canine and left first premolar)
and mild periodontal disease.
• The teeth were splinted using a 4-unit metal-ceramic fixed
partial denture. Resilient extra-coronal ball attachments
(Servo Dental, Hagen Halden, Germany) were placed at the
left central incisor and left first premolar for direct retention .
Rest seats were prepared.

9. Fig 1: Intraoral view of patient
Extracoronal ball
attachment.
4 unit metal ceramic
FPD
Rest seat

10. Fig 2: final impression with
polyvinyl siloxane.
Fig 3: obturator frame work on
Master model.

11. Fig 3: Processed prosthesis Fig 4: final fitting in mouth.

12. CASE 3-Hybrid Maxillofacial Prosthesis
A patient aged 52 years who reported to the department of
Prosthodontics, Coorg Institute of Dental Sciences, Virajpet,
Coorg, with the complaint of missing anterior teeth . On
examination it was found that this was a case of congenital
Palatopharyngeal malformation of the palatal insufficiency
category coupled with bilateral cleft lip . According to LAHSAL
classification, proposed by Okriens in 1987, this case was
classified as L-A-H-S-A-L , which means the defect involves the
right lip, right alveolus, hard palate, soft palate and left lip
with missing 11 and 12.

13. Fig 1: Extraoral appearance. Fig 2: Intraoral appearance

14. Fig 3: wax up for obturator. Fig 4: special type of clasp to
Retain lip prosthesis

15. Fig 5 : Hollow bulb obturator
With special clasp.
Fig 6: wax try-in

16. Fig 7: Impression of wax up. Fig 8: Stained acrylic packed
in the impression.

17. Fig9: acrylized prosthesis
With labial extension.
Fig 10: Try- in of the prosthesis

18. Fig 11: Harvested hair filled
With self cure acrylic. Fig 12: final prosthesis in place.

19. Initial appearance Fig 13: final extraoral appearance