Prosthodontic rehabilitation of a sub-total maxillectomy defect with a definitive hollow obturator prosthesis using the modified lost-wax concept: A novel technique

Squamous cell carcinoma (SCC) of the oral cavity is relatively common in the Indian subcontinent with surgical resection and adjuvant radiotherapy/chemotherapy being the treatment modality of choice. Prosthetic rehabilitation with an obturator following resection is more economical and yields satisfactory results. Better patient acceptance and comfort necessitates hollowing the prosthesis to a great extent. This novel method modifies the existing lost-wax technique in fabricating a definitive hollow maxillary obturator. An elderly man had reported to the Department of Prosthodontics with the chief complaint of a “big hole” in the mouth which affected his quality of life. He had undergone subtotal maxillectomy, following a histopathologic diagnosis of SCC, with adjuvant radiotherapy. Examination revealed an Aramany Class II defect with the healthy oral mucosa. A lightweight definitive obturator was designed and fabricated using a simple technique which utilizes easily available modeling wax. This article describes a relatively simple, single-step fabrication of a closed hollow-bulb obturator prosthesis with a uniform thickness of heat-cured resin encapsulating the hollow prosthesis.