Prosthetic Rehabilitation of a Congenital Soft Palate Defect

Abstract

Obturator is derived from the Latin verb obturate which means to close or to shut off. This definition provides an appropriate description of the objective of obturation in patients with palatal defects. The obturator is often helpful in improving the speech of individuals with partial or total velar defects i.e. cleft of soft palate. Soft palate cleft is one of the most common cause of velopharyngeal incompetence, which is the functional inability of the soft palate to effectively seal with the posterior and or lateral pharyngeal walls. In maxillofacial prosthesis the clinician may have the responsibility for reestablishing palatopharyngeal integrity to provide the potential for acceptable speech. Here a case report has been presented in which palatal plate with a solid one piece pharyngeal obturator prosthesis has been used for rehabilitation of a dentulous patient having congenital soft palate defect using functional impression technique.

Keywords: Hypernasality; Pharyngeal obturator; Retention; Soft palate; Speech aid; Velopharyngeal (VP) insufficiency.

Fig. 1

Intra oral view showing the soft palate defect

Fig. 2

Putty, light body impression of the defect

Fig. 3

Cast showing the defect

Fig. 4

Oral section of the obturator with posterior part trimmed off

Figs. 5, 6

Attachment of palatal loop with the ligature wire to the oral part

Fig. 7

Addition of cold cure acrylic resin to the loop

Fig. 8

Recording of the defect with functional impression

Figs. 9, 10

Functional impression of the defect

Fig. 11

Pick up impression of the prostheses

Fig. 12

Master cast showing the exact recording of the defect

Fig. 13

Prostheses placed on the cast for cold cure acrylic resin addition

Fig. 14

Final obturator prostheses showing the pharyngeal section

Fig. 15

Intra oral view of the speech aid prostheses