Quick technique for construction of a surgical obturator

Fig. 5. Stone cast and die ready for waxing. 4. Remove and peel out silver wax spacer. This creates a rigid close-fitting tray (Figs. 2 and 3). 5. Retract the gingiva with rings or cord. 6. Remove the retraction cords or rings. 7. Mix a suitable polysulfide base impression material and inject around the prepared tooth or teeth. Place only in the half of tray that covers prepared teeth. (It is not necessary to place in the other half of the tray, because Speed Tray will make a good impression of the opposing teeth.) Instruct the patient to close in centric relation and hold until set. Remove the impression after it has set (Fig. 4).

Quick technique for co William

Fig. 6. Finished restoration.

8. Pour the casts in artificial stone (Fig. 5). 9. Finish the crown (Fig. 6). t&pm request> In: DR. GERALD hi. HILL 1002 SPRISC AVE. IA GRASDE, OR 97850

uction of a surgical obturator

S. Disantis*

New Orleans, La.

M

axillary surgical defects produce functional conditions in which speech and swallowing are dif%ult because food and fluids are forced into the defect during function.’ The immediate surgical obturator provides a base for the dentist on which surgical packing and/or tissue conditioner are placed and enables the patient to speak and swallow postoperatively.’ Occasionally, the prosthesis is constructed at the last moment. A simple method to quickly construct an intraoral surgical maxillary obturator is described in this article.

TECHNIQUE 1. Make an irreversible hydrocolloid impression. 2. Pour the presurgical impression with a mixture of dental stone and slurry water, which increases the setting time of gypsum3 (Fig. 1). ‘Certified

128

Dental Technician

Fig. 1. Presurgical cast. JANUARY

1985

VOLUME

53

NUMBER

1

SURGICAL

OBTURATOR

Fig. 2. Cast trimmed compound adapted.

with wrought

wire and block-out

3. With the surgeon, determine on the cast the extent of the surgery and how retention can be obtained from the remaining teeth. 4. Trim the cast on the surgical site to the proper depth and contour of the maxillary arch form.4 Adapt wrought wire clasps and contour concave defects with blockout compound (Block Out Compound, Buffalo Dental Mfg. Co., Inc., Brooklyn, N.Y.) (Fig. 2). 5. Soak the cast in slurry water to act as a separator medium during fabrication. 6. Preheat the dental molding machine (Biostar, Scheu-Dental, Iserlohon, West Germany; and Great Lakes, Buffalo, N.Y.), which uses air pressure for better adaption of plastic sheets. 7. Place an autopolymerizing acrylic resin (Biocryl, Scheu-Dental, Great Lakes) on the wrought wire loops for adhesion with the plastic sheet. A 3 mm sheet (Clear Imprelon, Scheu-Dental, Great Lakes) is used for an adeq;ate peripheral roll (Fig. 3). 8. Remove the cast after the adapted sheet is allowed to cool. 9. Trim the excess plastic with an acrylic resin wheel and burs on a bench lathe. 10. Polish the borders in the same fashion as for a denture base, and perforate for placement of circumzygomatic wire for added retention (Fig. 4). 11. Cleanse the finished surgical obturator and store in disinfectant until placement in the mouth.4

Fig. 3. Surgical obturator

Fig. 4. Imprelon insertion.

resin

formed in rigid Imprelon.

surgical

obturator

ready

for

REFERENCES 1.

2. 3. 4.

Beumer III, J., Kurraschm, hI., and Kagawa, T.: Prosthetic restoration of oral defects secondary to surgical removal of oral neoplasma. CDA J l&47, 1982. Birnbach, S.. Immediate surgical sectional stent prosthesis for maxillary resection. J PROSTHFI. DEN,I‘ 39:447. 1978. Skinner, E.W., and Phillips, R. W.: Sciencr of Dental Materials, ed 7. Philadelphia, 1973, W. B. Saunders Co.. p 63. Beumer, J., Curtis, T. A., and Firtell, D. XL‘.:Maxillofacial Rehabilitation, ed 1. St. Louis, 1979, The C. V. hlosby Co., p 210.

SUMMARY This procedure results in the quick fabrication of a surgical maxillary obturator. THE JOURNAL

OF PROSTHETIC

DENTISTRY

129