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This clinical report describes how a hollow obturator prosthesis was designed and fabricated for an 82-year-old partially edentulous patient with a large palatal defect. Computer-aided design (CAD) was used to design, articulate, and align the mandibular denture with the obturator prosthesis. The prosthesis was printed, adjusted chairside, rescanned, and made hollow by using a CAD software program. The prosthesis was printed in resin with a dental 3D printer. Quantitative evaluations of clinical (prosthesis dimensions, rest, and occlusal vertical dimensions) and virtual (surface area, volume, weight, interpoint mismatches, spatial overlap) parameters found that the 3D-printed prosthesis required an additional 5% chairside modification. The greatest differences in volume (24.7% less) and weight (22.2% less) were observed when the modified obturator bulb was made hollow via CAD. Hollowing the bulb, therefore, reduced the spatial overlap in volume by 16.8%.

The objectives for complete denture fabrication are to provide comfort, function and aesthetics. The availability of implant-assisted overdentures has benefited complete denture wearers; however, the success of the prostheses can be further enhanced when the neutral zone concept is incorporated as a mean to locate the correct position of the implants, as well as the tooth arrangement for optimal outcome of the prescribed prostheses. CPD/Clinical Relevance: Use of the neutral zone concept to assist implant placement and teeth setting in a severely resorbed edentulous mandible is beneficial.

BACKGROUND: Two patients received ocular injuries from rusted metallic projectiles at their industrial workplaces. Said injuries resulted in the loss of their eyes by evisceration surgeries to prevent fatal infections. CASE DESCRIPTION: The first case, a man in his twenties, received a stock conformer immediately after surgery and started prosthetic therapy within 2 months. The second case, a man in his forties, started prosthetic therapy after 10 years. Definitive custom ocular prostheses were fabricated and relined according to conventional protocol. RESULTS: On issue of the prosthesis, there was adequate retention, aesthetics and stability to extra-ocular movements and treatment was considered successful for both cases. However, follow-ups showed noticeable prosthetic eye movements for case 1 which, to some extent mimicked the physiologic movement of its fellow natural eye. Case 1 adjusted to his prosthesis better while case 2 was still adjusting with little to no physiologic movement. CONCLUSION: Prosthetic rehabilitation should be started as early as possible to obtain optimum rehabilitative results.

Potential excessive removal of tooth structure during retreatment, and canal preparation for a post will weaken the tooth substantially. An alternative to prefabricated or cast metal and fibre posts, is a soft and flexible fibre-reinforced composite post that can be used to aid a good adaptation and preserve the tooth structure. These two case reports highlight the use of fibre-reinforced composite posts in teeth with severe loss of tooth structure with wide flared and oval canals. CPD/Clinical Relevance: Case selection and proper treatment planning are important before considering and selecting any type of post placement.

Purpose: For making denture in maxillectomy cases is very difficult and challenging to get the retention tomake the denture stable in its position during functioning. This case report describes a clinical condition inwhich patient was treated with a maxillary obturator with zygomatic suspension wiring due to insufficientretention in the palate. Materials and Methods: A 63-year-old patient had gone to a subtotal maxillectomybecause following myofibroblastic sarcoma andwas issued with bilateral circum-zygomatic wiring hooksimmediately after surgery. The patient had less than a third of their alveolar ridge remaining and did notprovide sufficient retention on its own. The wires were used for the retention because natural retentioncould not get due to inadequate maxillary ridge. While the denture was being fabricated, a temporaryfeeding plate was provisioned to the patient. Counter hooks were implemented on the definitive upperdenture, posterior to molars, to attach to the zygomatic suspension hook. Final upper denture was furtherreinforced with denture adhesive on it. A lower denture was also fabricated for the said case followingconventional protocols of jaw relation determination. Results: The obturator provided with adequate sealand leak proof phonetics. The zygomatic wiring coupled with denture adhesive were sufficient to provideadequate retention. Conclusion: Zygomatic suspension wires coupled with counter hooked obturatorprosthesis provide rehabilitation of patients with palatal defects with inadequate maxillary arch forretention.However long-term repeated use of such wires might expose the patient to secondary infectionsand should be kept in consideration Clinical Significance: Circum-zygomatic suspension wiring providesufficient retention to sustain the upper obturator prosthesis in place. However, the retention was stillinadequate, so denture adhesives were used to make it more stable. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.582-585