Palatal obturator designed by 3-dimensional prototyping for a patient with a large ameloblastoma: a case report.

The aim of the present report was to detail the advantages of using 3-dimensional (3D) prototyping in the planning, modeling, and manufacturing of an immediate palatal obturator for a 62-year-old man who underwent a left total maxillectomy to remove a solid, multicystic ameloblastoma. The prosthesis provided favorable restoration of stomatognathic functions, including speech, swallowing, and mastication. The use of an immediate obturator prosthesis made with 3D technology is an important aid in the treatment of patients diagnosed with tumors in the head and neck region.

Oropharyngeal Geometry of Maxilectomized Patients Rehabilitated with Palatal Obturators in the Trans-surgical Period: Repercussions on the Voice.

INTRODUCTION: Patients undergoing maxillectomies may present alterations in the stomatognathic functions involved in oral communication. Rehabilitative treatment should favor the rescue of these functions, through surgical flaps, obturator prostheses or both. OBJECTIVES: The present study aims to present the impact of the use of the palatal obturator on the oropharyngeal geometry and on the voice of patients undergoing maxillectomies, after adaptation to trans-surgical palatine obturators (TPO). METHODS: Twelve patients treated at a Cancer Hospital, submitted to maxillectomy and rehabilitated during surgery were evaluated. The oropharyngeal geometry was measured by acoustic pharyngometry and the vocal parameters were evaluated through auditory-perceptual and acoustic analyses. The comparison between the results with and without TPO was analyzed using the Wilcoxon test and the correlation between oropharyngeal measurements and acoustic parameters using Spearman's correlation coefficient, all with a significance level of 5%. RESULTS: There was a decrease in the following oropharyngeal measurements with the use of TPO: length of the pharyngeal cavity and vocal tract, volume of the oral cavity, pharyngeal and vocal tract and area of ​​the oropharyngeal junction. There was no difference in the length of the oral cavity and in the glottic area between situations with and without TPO. In the vocal evaluation, changes in intelligibility and resonance were observed in the situation without TPO and, in only one case, mild hypernasality was detected in the situation with TPO. CONCLUSIONS: It is concluded that the use of TPO brought the oropharyngeal measurements closer to normal values ​​and provided an improvement in speech intelligibility and vocal resonance in maxilectomized individuals.

Radioterapia em tumores de boca / Radiotherapy in tumors of mouth

O câncer de boca continua constituindo-se, pelos altos índices de mortalidade, em um problema nacional de saúde pública. O objetivo deste estudo foi o de verificar, através de revisão da literatura, as indicações, aplicações e repercussões da radioterapia em tumores de boca. Os resultados evidenciaram que, em alguns casos, a radioterapia pode ser tão eficaz quanto a cirurgia, desde que adequadamente indicada, realizada e respeitadas as particularidades do paciente, estadiamento e localização do tumor. As repercussões bucais devem ser minimizadas através de planejamento e cuidados pré-radioterapia. Conclui-se que é necessária a atuação prévia do cirurgião-dentista, a fim de minimizar as repercussões bucais da radioterapia, além de sua atuação, de modo a favorecer o diagnóstico precoce e diferencial das lesões de boca.

Oral cancer is still being the high rates of mortality in national public health problem. The aim of this study was to verify the information in the literature, applications and implications of radiotherapy in mouth?s tumors. The results show that, in some cases, radiotherapy may be as effective as surgery, if properly displayed, performed and complied with the particular patient, stage and tumor location. The oral effects should be minimized through planning and pre-radiotherapy. It is necessary that the prior action of the dentist in order to minimize the effects of oral radiotherapy in addition to its performance in order to promote the early and differential diagnosis of mouth?s lesions.