Digital Blueprint to Traditional Craftsmanship: Rehabilitation of a Traumatic Maxillary Defect with a Definitive Obturator - A Case Report

Sep 23

1 min read

1. Dr. Agarwal Nirali Jitendra, Postgraduate Trainee, Department of Prosthodontics, Crown and Bridge and Implantology Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University) Bhubaneswar, Odisha, India – 751003, Email: dr15nirali@gmail.com, ( Corresponding author ) ORCID: 0009-0005-8251-1043

2. Dr. Abhijita Mohapatra, Professor, Department of Prosthodontics, Crown and Bridge and Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University)

Bhubaneswar, Odisha, India - 751003, Email: abhijitamohapatra@soa.ac.in, ORCID: 0009-0009-8151-8584

Abstract

Acquired maxillary defects can produce persistent oro-nasal or oro-antral communication and compromise speech, swallowing, mastication, and prosthetic function. Definitive obturator prostheses provide a conservative means of restoring separation of these cavities when prosthetic rehabilitation is indicated. This case report

describes rehabilitation of a 47-year-old man with a six-year-old traumatic hemimaxillary defect following a bomb-blast injury. The defect was classified as Aramany Class I. A two-step elastomeric impression was made, and the definitive framework was planned digitally using Exocad. The design incorporated cross-arch support and retention from the residual dentition and palate, with a perforated mesh over the defect to retain the acrylic resin component. After clinical verification of the metal framework, jaw relation recording and tooth arrangement were completed, followed by acrylic processing and insertion. At one-year follow-up, the prosthesis remained clinically serviceable, with no reported nasal regurgitation and no patient-reported difficulty with speech or mastication. This case demonstrates a combined digital-conventional approach in which digital framework planning was integrated with established biomechanical principles of obturator prosthodontics.

Keywords: maxillary defect; definitive obturator; Aramany Class I; maxillofacial prosthodontics; CAD/CAM;

digital framework.