Abstract
When most of the upper jaw is lost by ablative surgery for a malignant tumor, a dento-maxillary prosthesis combined with an obturator is usually applied in order to rehabilitate the function of both mastication and speech and to improve the facial deformities. We present a case of a fabricated dento-maxillary prosthesis supported by dental implant following subtotal maxillectomy. The patient was a 51-year-old female. She was referred to our clinic by a dentist for examination of her upper palatal swelling. A biopsy was carried out and the histological diagnosis determined an adenoma. Surgical operation was done under general anesthesia. However, a pathologist found malignant cells by serial sectioning of the surgical specimen and finally diagnosed adenocarcinoma. Therefore, subtotal maxillectomy was performed immediately. After the radical surgery, the patient had no recurrence for seven years. She had used a dento-maxillary prosthesis combined with an obturator supported by her upper remaining teeth and alveolar bone. Unfortunately, the prosthesis became unstable due to loss of her hinge teeth caused by chronic periodontitis. We designed an implantsupported dento-maxillary prosthesis with dolder-bar type attachment. The dolder bar attachment was supported by three osseointegrated implants in her maxilla. After applying the implant-supported dento-maxillary prosthesis, her oral functions including mastication, deglutition and speech have been considerably improved for six years and seven months. The patient is highly satisfied with the prosthesis.
