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Volume : 5 | Issue : 2 | Page : 143-146

for
Reddy
Prosthodontics,

fabricating
Sridevi1, Natarajan
Crown

and

Bridge,

hollow

obturator:

Kalavathy1, Narasimha
D.A.P.M.R.V.

Dental

College

and

Two

Sridevi JR

case

reports

Kalavathy

Jayanthi2, Narasimhaiah

Manjula1

Jayanthi N

Manjula N

Hospital,

Bengaluru,

Karnataka,

India

rosthodontics, Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India

blication

7-May-2014

Search in Google
Address:
Manjula

osthodontics, Crown and Bridge, D.A.P.M.R.V. Dental College and Hospital, J.P. Nagar, 1st Phase, Bengaluru - 560 078, Karnataka

Sridevi JR

Kalavathy

Jayanthi N

Manjula N

76-433X.132097

only seen intraoral defect is the one affecting the maxilla, through an opening into the nasopharynx. These defects can either be
quired. These are usually large openings in the palate and/or the surrounding structures. Obturators are used to close or seal
o restore proper mastication, speech, deglutition, and esthetics. This article presents case reports describing two different
bricating hollow bulb oburator.

ow bulb, obturator, shim

article:
vathy N, Jayanthi N, Manjula N. Techniques for fabricating hollow obturator: Two case reports. SRM J Res Dent Sci 2014;5:143-6

Related articles

Hollow bul

obturator

shim

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URL:
vathy N, Jayanthi N, Manjula N. Techniques for fabricating hollow obturator: Two case reports. SRM J Res Dent Sci [serial online]
Nov 17];5:143-6. Available from: http://www.srmjrds.in/text.asp?2014/5/2/143/132097

* Registratio
In this article
Abstract
Introduction
Case reports

a device that is used to close any unnatural opening intraorally. This is usually a defect in the maxilla such as cleft palate or
maxilla.

Discussion

ous ways of fabricating the open and closed hollow obturator. All these techniques intend to provide a light weight prosthesis that
ted by the patient. The open bulb obturator provides the advantage of easy cleans ability, but accumulation of moisture
equent cleaning. [1] Removable lids or the covering of the obturator prosthesis usually reduces this disadvantage.

Article Figures

available to fabricate a hollow bulb obturator include the fabrication of an obturator either as one piece or by processing in two
ng using autopolymerizing resin. [2] One piece hollow bulb obturator can be fabricated by filling the hollow portion using materials
salt, polyurethane foam, sponge [4] and gas injection using argon gas. [5] Nondetachable screw cap can also be used to cover the
made
to
pour
out
the
sugar
or
salt.

resents

References

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two

case

reports

describing

two

different

techniques

used

to

fabricate

the

hollow

bulb

obturator.

esent here is about a 59-year-old female patient who came to the Department of Prosthodontics, DAPM R V Dental College,
he complaint of missing teeth and closure of defect in the upper arch. Patient had undergone hemimaxillectomy due to squamous
carcinoma
of
the
palate.
procedure

on was made using alginate [Figure 1]. Primary cast was made and special tray was fabricated. Border molding was done using
pound. And final impression was made using elastomeric impression material [Figure 2]. Master cast was thus, obtained over
ase was fabricated. Jaw relation was done. Teeth arrangement was done and tried in patient's mouth[Figure 3].

Figure 1: Alginate impression

Click here to view

Comments

Figure 2: Final impression

Click here to view

Figure 3: Trial in
Click here to view

of

the

lid

portion of the obturator was done [Figure 4]. It was flasked, dewaxed, packed and processed separately.

Figure 4: Wax pattern for lid

Click here to view

of

the

trial

denture

was flasked and dewaxed [Figure 5]. Heat cure acrylic resin was packed into the mold and acrylic was processed. The lid was
urator [Figure 6] and sealed using autopolymerizing resin. The obturator was finished and polished.

Figure 5: Dewaxing
Click here to view

Figure 6: Obturator with lid

Click here to view

e is about a patient 59-year-old female came to the Department of Prosthodontics, DAPM R V Dental College, Bangalore, with a
acement of missing teeth. Patient gave a history of teeth being extracted during maxillectomy due to carcinoma of maxilla. One
ollow
bulb
obturator
was
planned
to
restore
the
defect.
procedure

on of the defect and surrounding structures was made using alginate [Figure 7]. Primary cast obtained on which special tray was
er molding was done using green stick compound and final impression was made using elastomeric impression material. Denture
on the master cast obtained. Occlusal rims were fabricated and jaw relation was recorded. This was followed by a try in
e 8].

Figure 7: Alginate impression

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Figure 8: Teeth arrangement

Click here to view

technique

s flasked and dewaxed. Undercuts were blocked out with 2 mm of wax in the defect area. Three tissue stops were then made in
r layer of wax was adapted on the opposing palatal surface. Autopolymerizing resin was mixed and added on the area relieved
defect and the palatal surface. The two halves of the flask were closed and the resin was allowed to polymerize. A hollow shim
ed [Figure 9]. The wax used for relief was washed off using boiling water. This hollow shim was placed back in the flask using the
[Figure 10]. Heat cure acrylic resin was mixed and packed into the flask. Shim was thus encased within the obturator. The acrylic
sed, finished and polished [Figure 11].

Figure 9: Hollow shim

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Figure 10: Packing with shim in position

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Figure 11: Final prosthesis

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ge maxillectomy defects present a significant challenge for prosthetic rehabilitation. Retention is severely compromised in these
g in difficulties in speech and mastication. The technique described in this article for the fabrication of the hollow bulb obturator
y Chalian and Drane [1] The hollow bulb obturator offers many advantage of being light and reduces excessive atrophy of muscles.

ave described various other techniques for the fabrication of the hollow bulb obturator. Matalon and LaFuente [3]described the
ing sugar during processing of the obturator, which is later removed by drilling a hole in the superior surface and the hole is filled
merizing
resin.
The
opening
can
also
be
filled
by
using
a
nondetachable
screw
cap.

described the two flask technique to process the obturator and the tooth portion separately. Mc Andrew et al. [2]described the
icating the prosthesis in two halves and sealing them using autopolymerizing resin. Iramaneerat et al. [5]described the technique of
argon
gas
into
the
bulb
of
the
obturator.

described the use of hard thermoforming splint to fabricate closed hollow bulb obturator. Plaster index was used as a matrix for
fabrication
of
hollow
obturator
by
Asher et
al. [8]

ues described in this article have more advantages than disadvantages. The advantages of fabricating one piece obturator are; it
e esthetic, simple, and accurate and there are no lines of demarcation between heat cure and autopolymerizing resin. It also
the
speech
by
adding
resonance
to
the
voice.

es of one piece obturator are: increased processing time, shim or polyurethane foam increases the weight of the prosthesis.

of a two piece obturator are; the thickness of the obturator can be controlled thereby reducing the weight of the prosthesis. [9],[10],
clinical
time.
It
can
be
used
for
both
completely
and
partially
edentulous
arches.

es are; additional processing time required to process the lid, acrylic resin may seep into the hollow portion of the obturator,
s is possible if the seal is improper. Two piece obturator is mainly used in large defects with more undercuts or in patients with
mouth
opening.

us techniques, the technique described by Chalian et al. is being followed for decades due to the advantages described above.

VA, Drane JB. Maxillofacial Prosthetics - Multidisciplinary Practice, Baltimore: The William and Wilkins Co.; 1972.

w KS, Rothenberger S, Minsley GE. 1997 Judson C. Hickey Scientific Writing Awards. An innovative investment method for the
n of a closed hollow obturator prosthesis. J Prosthet Dent 1998;80:129-32.

V, LaFuente H. A simplified method for making a hollow obturator. J Prosthet Dent 1976;36:580-2.

LJ, Heupel EM. Prosthetic restoration of a maxilla and associated structures. J Prosthet Dent 1966;16:154-68.

rat W, Seki F, Watanabe A, Mukohyama H, Iwasaki Y, Akiyoshi K, et al. Innovative gas injection technique for closed-hollow
Int J Prosthodont 2004;17:345-9.
AS. Processing a hollow obturator. J Prosthet Dent 1969;22:682-6.

MM, Ariffin YT, Yunus N. Closed hollow bulb obturator - One-step fabrication: A clinical report. J Prosthodont 2013;22:591-5.

, Psillakis JJ, Piro JD, Wright RF. Technique for quick conversion of an obturator into a hollow bulb. J Prosthet Dent 2001;85:419-

, Gold HO, Pruzansky S. A simplified technique for fabricating a lightweight obturator. J Prosthet Dent 1977;38:638-42.

J, Shipmon TH. The hollow bulb obturator for acquired palatal openings. J Prosthet Dent 1957;7:126-37.

E. Clinical considerations improving obturator treatment. J Prosthet Dent 1970;24:461-6.

e 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11]

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05 November, 2012