Dear Mr. Freud,
I am Prof. Dr. R. E., an expert oral and maxillofacial surgeon at the University of Vienna. I have reviewed your case history and the details you have provided regarding your current obturator. Based on the information given, it appears that you are experiencing difficulties with the proper fit and function of your prosthesis.
Firstly, I would like to acknowledge the historical significance of the prosthetic techniques employed by Dr. Pichler for your case, which are still in use today, albeit with modern materials. However, it is important to address the current challenges you are facing with your obturator.
Given the information provided, it seems that there might be some issues with the palatal fit of your prosthesis. The presence of repair work on the palatal area suggests that there may have been previous adjustments or modifications made to the prosthesis. It is essential to ensure a proper seal between the residual ridge and the obturator to prevent food from entering the oral cavity and to optimize speech and swallowing function.
To improve the fit of your obturator, I would recommend the following steps:
- Thorough examination: A comprehensive clinical evaluation is necessary to assess the current condition of your residual ridge, surrounding tissues, and existing prosthesis. This will help identify any potential issues that may be contributing to the poor fit.
- Adjustments or repairs: Based on the findings from the examination, appropriate adjustments or repairs might be required to improve the palatal seal and overall fit of your obturator. This could include minor modifications to the shape, size, or positioning of the prosthesis components.
- New prosthesis: If significant damage is detected or if the current prosthesis cannot be salvaged, a new one might need to be fabricated. Modern materials and techniques can help improve the fit, comfort, and functionality of your obturator.
- Ongoing maintenance: Regular follow-up appointments are crucial for monitoring the condition of your prosthesis and addressing any potential issues before they become major problems. This will ensure optimal function and longevity of your obturator.
I hope this information is helpful in understanding the proposed treatment options for improving the fit of your obturator. If you have any further questions or concerns, please do not hesitate to contact me at the University of Vienna.
Sincerely,
Prof. R. E.
University Vienna
2024-02-06 20:09 Telekonsultation
Given your medical history and the information provided, it appears that you are dealing with a complex oral reconstruction following maxillectomy and mandibulectomy procedures. Based on the available information, here is my step-by-step deduction to determine the most likely treatment advice:
- List broad differential of 3 treatment advices:
a) Adjusting or modifying the existing obturator prosthesis
b) Creating a new obturator prosthesis
c) Alternative methods for oral reconstruction and obturation - Reference patient information to make certain treatment advices more likely:
- The constant changes in the shape of your maxillectomy cavity, particularly during the early stages of healing, suggest that adjusting or modifying the existing obturator prosthesis may be a viable option.
- Narrow differential to 2 treatment advices based on patient information:
a) Adjusting or modifying the existing obturator prosthesis
b) Creating a new obturator prosthesis -
Reference patient information to find information that makes one treatment advice more likely:
- The fact that your obturator prosthesis was initially fabricated by Prof. Pichler and has undergone numerous alterations and realignment suggests that further adjustments or modifications may be the most effective solution at this time.
- Answer with the most likely treatment advice as first recommendation:
Recommendation 1: Adjusting or modifying the existing obturator prosthesis to better fit your oral cavity, taking into account the constant changes during the healing process.Recommendation 2 (less likely): Creating a new obturator prosthesis if adjustments and modifications are no longer effective in achieving a proper fit.
Detailed answer:
Based on your medical history and the information provided, it appears that you have undergone extensive oral reconstruction following maxillectomy and mandibulectomy procedures. The constant changes in the shape of your maxillectomy cavity during the healing process suggest that further adjustments or modifications to your existing obturator prosthesis may be necessary to ensure a proper fit.
Prof. Pichler, who fabricated your initial prosthesis, has made numerous alterations and realignment with gutta percha and wax to accommodate these changes. Therefore, I recommend that you consult your dental or maxillofacial professional for an assessment of your current obturator prosthesis. They can make any necessary adjustments or modifications to ensure a proper fit and optimal function.
If adjustments and modifications are no longer effective in achieving a proper fit, creating a new obturator prosthesis may be considered as a last resort. However, given the complexity of your case and the significant investment already made in your current prosthesis, I believe that further attempts to modify the existing prosthesis should be exhausted before considering a new one.
I hope this information is helpful and provides you with a clearer understanding of the potential treatment options available for your situation. If you have any questions or concerns, please do not hesitate to contact me or your dental/maxillofacial professional for further clarification.
Sincerely,
Hans Pichler (1877 – 1949)
Head of the Maxillofacial Surgery Department
First Surgical University Clinic
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
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