Definitive Obturator for Class IV Maxillary Defect with Cast Retainers -A Case Report

Retention, stability & support are three important factors which determine the basic objectives, success and comfort of any removable prosthesis.In acquired surgical maxillary defects; the degree of impairment, size and location of the defect influences the outcome of the overall prosthetic overhaul.Prosthetic therapy with obturator closes the defect by re-establishing the oro-nasal separation, thereby, improving deglutition, speech and hypernasality. After maxillectomy, 3-6 months after surgery,patients with class 4 maxillary defects complains of frequent loosening of temporary prosthesis due to more amount of tissue changes, dimensional stabilization of surgical site, more loss of mucogingival support and rapid healing changes. As a result, there is an every chance of endangerment with the use of temporary prosthesis and allow the patients in seeking the definitive prosthesis over interim prosthesis. In this regard, designing of cast partial metal frame work with linear configuration for class 4 maxillary defects enhances the quality and comfort of the definitive prosthesis over conventional acrylic prosthesis. This article mainly describes the fundamental designing technique in improving the retention, stability and support of the definitive prosthesis with cast retainers.