Dental approach in immediate rehabilitation after maxilectomy: case report

Abstract

Objective: to demonstrate the importance of Dentistry in the oral rehabilitation of patients with malignant neoplasia. Case Report: patient M.C.F., female, 43 years old, with diagnosis of mucoepidermoid carcinoma of the right maxillary sinus. In 2009, the patient was subjected to radiotherapy and chemotherapy with full response. However, in 2015 there was recurrence of the lesion and the patient was referred to the Barretos Cancer Hospital. At the examination, it was observed edema and preserved mucosa in the region of hard palate and f loor of nasal fossa on the right side. The treatment proposal was surgical resection of the lesion and rehabilitation with a palatal obturator prosthesis. The patient underwent clinical and radiographic examination by a dentist, who observed tooth 25 with a coronal fracture and endodontic treatment without periapical lesion at the radiographic examination and no symptomatology. Due to the previous radiotherapy, it was decided to seal the tooth with glass ionomer cement and maintain the root. Prior to surgery, professional pumice prophylaxis was performed, oral hygiene instructions were given and an impression was taken for fabrication of a alatal obturator plate. Following the treatment plan, the oral cavity was reestablished immediately after the maxillectomy with the installation of a palatal obturator plate. Two months after resection of the lesion, the patient presented significant trismus and complained about esthetics. Due to the impossibility of taking an impression, it was decided to duplicate the plate that the patient was already using in order to fabricate a palatal obturatorprosthesis. Conclusion: the installation of the prosthesis restored the masticatory functionand improved speech and esthetics, contributing
to the patient’s reintegration into her social life.