Chelyabinsk, Chelyabinsk, Russian Federation
employee
Chelyabinsk, Chelyabinsk, Russian Federation
Chelyabinsk, Chelyabinsk, Russian Federation
UDC 616.31
Upper jaw defects after radical surgeries for malignant tumors of the maxillofacial area remain one of the most difficult tasks of maxillofacial orthopedics. The purpose of the current study is to analyze clinical and rehabilitation approaches to prosthetics of postoperative defects of the upper jaw, to evaluate the effectiveness of obturational prostheses and modern digital technologies (CAD/CAM, 3D printing) at the stage of early and delayed rehabilitation. During the project (2019–2025), 55 patients were examined, including 18 men (32.7%) and 37 women (67.3%), aged 20–70+. All patients underwent extended radical surgeries, resulting in postoperative defects in the upper jaw. The defects of the upper jaw that developed after surgical intervention were diverse, and depended on the localization of the tumor process and the volume of the surgery; three-step prosthetic approaches were used: surgical obturator, forming prostheses in postoperative adaptation and the final obturating prosthesis. The use of innovative small obturating prostheses and cap-prostheses allowed to reduce the rehabilitation time and significantly improve functional outcomes. Regardless of the stage of prosthetics, patients used an intermediate stage: the production of a temporary small obturating prosthesis by the analog method, or a cap-prosthesis made using digital technologies. The purpose of the intermediate stage is to ensure complete isolation of the nasal cavity from the air-water flow during dental manipulations (hygienic procedures, dental treatment, implantation, preparation for fixed structures). Small obturating prostheses are used as independent prostheses in the first stage of rehabilitation and as temporary elements during the production of permanent prostheses, which helps to restore the patient's quality of life more quickly. Conclusion The results of this study demonstrate that significant functional impairments and cosmetic deformities are possible after maxillary resections, closely related to the extent and location of the defect. The introduction of CAD/CAM technologies and 3D printing for the production of mouthguards and forming elements has improved the accuracy of the implant bed and, in some cases, reduced manufacturing time. However, standardization of approaches and further study of their effectiveness are needed.
malignant neoplasms of the maxillofacial region, defects of the upper jaw, obturating prostheses, prosthetics after resection, CAD/CAM prosthetics, rehabilitation
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