Modification of existed prosthesis into a flexible wall hollow bulb obturator by permanent silicone soft liner for a hemimaxillectomy patient with restricted mouth opening.

PATIENT: A patient of hemimaxillectomy with restricted mouth opening, wearing a hard acrylic bulb obturator encountered difficulty in insertion and removal of the prosthesis. The prosthesis was converted into a open hollow bulb obturator with flexible walls with permanent silicone soft liner for easy insertion and removal.

DISCUSSION: Patients having acquired maxillary defects due to surgical resection of the maxilla often suffer with difficulty in mastication, swallowing, nasal regurgitation, speech disturbances and poor esthetics. Different types of obturator with various bulb designs most commonly fabricated from acrylic resins together with "acrylic resin plate and/or" metal framework are used to improve the quality of life of these patients by restoring the function. But restricted mouth opening in some of these patients makes it difficult to place and remove the prosthesis with hard acrylic bulb. Fabrication of flexible open hollow bulb and relining of remaining obturator with resilient permanent silicone soft liner makes easy insertion and removal of the prosthesis and also improve the retention by intimate contact of soft liner with the tissues.

CONCLUSION: Permanent silicone soft liner open hollow bulb obturator is a novel way for the functional rehabilitation of a hemimaxillectomy patient suffering with restricted mouth opening.