Abstract
Patients with maxillofacial defect after radiotherapy frequently suffer from trismus. Trismus makes it difficult to fabricate a maxillofacial prosthesis. In the present case, we attempted to improve xerostomia, articulation, mastication and swallowing with a three-piece maxillofacial prosthesis for a patient who had widespread maxillofacial defects and severe trismus. The patient was a 58-year-old man who had undergone heavy particle therapy due to osteosarcoma at the right maxilla three years before the first visit to our hospital. In spite of widespread maxillofacial defects on the right mid-face and maxilla caused by tissue necrosis, the prosthesis covered only the facial defects. Therefore, he suffered from severe xerostomia, dysarthria, trismus, dysmasesis and dysphagia. We aimed to fabricate a new maxillofacial prosthesis for tightly sealing the oral cavity and nasal cavity. This prosthesis was designed to have three parts （palatal plate, obturator and facial prosthesis） because of the severe trismus and complex form of the maxillofacial defects. The palatal plate and obturator were connected by magnetic attachments, and the facial prosthesis was connected with an obturator by the fitting structure. This prosthesis significantly improved xerostomia, articulation, mastication and swallowing.
