1) Immediate surgical obturators (ISOs) are placed during tumor resection to provide a matrix for surgical packing and reduce contamination, enabling speech and normal swallowing postoperatively. 2) ISOs are later relined and teeth added to serve as interim obturators during wound healing. 3) For radical maxillectomies, ISOs help restore facial contours and are wired to residual structures to support surgical packing. Skin grafts and ISOs work together to rehabilitate defects.

1. Surgical and Interim Obturation John Beumer III DDS, MS Distinguished Professor Emeritus UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

15. Radical Maxillectomy The surgical specimen is removed and the immediate surgical obturator (ISO) is placed in position. In this patient it was wired to residual dentition. The prosthesis serves as a platform for the surgical packing. When the wound is closed the facial contours are nearly normal

18. Radical Maxillectomy Preop Postop Note the lack of muscular tonus on the resected side represented by the drooping of the facial tissues and the corner of the mouth. Patient presented with an adenoid cystic carcinoma of the right maxillary sinus. Note the proptosis. A radical maxillectomy and orbital exenteration was required.

19. Radical Maxillectomy The patient five months later without his obuturator prosthesis (A). Facial nerve function has returned to near normal and the obturator prosthesis restores lip and midfacial contours. A The complete denture and obturator prosthesis has been inserted (B). B