Pre and post-surgical management of palatal perforations with obturator prostheses: description of a new classification, a modified operative protocol and a new evaluation test
Authors
Gian Luca Mascolo, Chiara Mariangeloni, Stefano Eramo, Stefano Pagano, Angelica Meriano, F. La Greca, Fausto Boschi, Claudio Da Silveira, Fabrizia Rueca, P. Durante, Salvatore Soldati, Giulia Amodeo, Sergio Marocco, Domenico Scopelliti
Abstract
This work aims at introducing a new classification for palatal perforation, an operative protocol for planning and realization of obturator prostheses that differs from the ones previously described in literature and a new test (Mascolo Questionnaire, MQ) for the evaluation of mastication, speech, deglutition and comfort experienced by the patients. These proposed instruments support and guide the clinician in an heterogenous pathological context where every lesion represents a unique case, with different tissue characteristics and psychological implications.
Materials and Methods
Prosthetic devices created with this workflow do not include bulbs and are built with multiple materials of different consistence; they seal the defect non-aggressively and aim at balancing the masticatory load, then protecting hard and soft tissues of the oral cavity. The protocol was applied to 40 patients previously wearing a traditional obturator with bulb. Patients received a questionnaire regarding the efficacy and acceptance of the prosthesis and the results were registered with a numerical value. A new obturator with no bulb and comprehensive of dissimilar materials’ layers was delivered to each one of the patients involved.
Results
Three months after the new prosthesis’ delivery patients received the questionnaire once again. The results were compared and the statistical analysis has been conducted, depicting a significant increase in the mastication, phonation, prosthesis sealing and comfort experienced.
Conclusions
Palatal obturators built with no bulb and through the workflow here proposed are more effective. Statistical analysis carried out on the data collected with the MQ Questionnaire shows that the difference between the answers given before and after the treatment is statistically significant, with significance level set at p<0.02 .
When wearing the new obturators patient can eat and drink comfortably, in a more effective way than with the previous prosthesis. The positive increase in speech comprehension supports the affected individuals when communicating with their medical staff, families and with strangers. Patients can then go back to a happy and healthy personal and relational life.
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