Unit Thirty Nine
Maxillofacial rehabilitation: Restoration of acquired hard palate defects Prosthodontic therapy for patients with acquired surgical defects of the maxilla can be arbitrarily divided into two phases of treatment with each phase having different objectives. The initial phase is called immediate surgical obturation and entails the placement of prosthesis at surgery immediately thereafter. This prosthesis must be modified at frequent intervals to accommodate for the rapid soft tissue changes that o留学作业定做ccur within the defect during organization and healing of the wound. The objective of immediate surgical obturation is to restore and maintain oral functions at reasonable levels during the postoperative period until healing is substantially completed. Three to four months after surgery the surgical site becomes stable dim6nsionany thus permitting construction of the definitive prosthesis, or the second phase of prosthodontic therapy. Immediate surgical obturation Immediate surgical obturation is particularly well suited for dentulous patients requiring a partial or total maxilleteomy because the remaining teeth can be used to help retain the prosthesis in position. The advantages of immediate surgical obturation are as follows: l. The prosthesis provides a matrix on which the surgical packing can be placed; on closure of the wound, the obturator maintains the packing in the proper relationship thus ensuring close adaptation of the skin graft to the raw surface of the cheek flap.
  2. The prosthesis reduces oral contamination of the wound during the immediate postsurgical period and may thus reduce the incidence of local infection.
  3. The prosthesis enables the patient to speak more effectively postoperatively by reproducing normal palatal contours and by covering the defect.
  4. The prosthesis permits deglutition: thus the nasogastric tube may be removed at an earlier date.
  5. The prosthesis lessens the psychologic impact of surgery by making the postoperative course easier to bear. The patient is reassured that rehabilitation has begun.
  6. The prosthesis may reduce the period of hospitalization (Nakamoto. 1971 ). This benefit assumes even greater importance with the escalating costs of hospitalization. There are several principles relative to the design of immediate surgical obturators that the prosthodontist should consider: l. The obturator should terminate short of the skin graft-mucosal junction. As soon as the surgical packing is removed, extension into the defect may be accomplished with interim soft reline materials.
  2. The prosthesis should be kept simple, lightweight, and inexpensive. Round 18-gauge wrought gold or stainless steel wire retainers are sufficient for dentulous patients.
  3. The prosthesis for dentulous patients should be perforated at the interproximal extensions with a small dental bur to allow the p留学作业定做rosthesis to be wired to the teeth at the time of surgery.
  4. Normal palatal contours should be reproduced to facilitate postoperative speech and deglutition.

  5. Posterior occlusion should not be established on the defect side until the surgical wound is well organized. If the patient is scheduled for a total maxillectomy with resection to the midline, the three maxillary anterior teeth included in the resection may be added to the prosthesis to improve esthetics.
  6. In some patients the existing complete or partial prosthesis may be adapted for use as an immediate surgical obturator. However, the arrange of the prosthesis corresponding to the proposed defect should be reduced and the posterior denture teeth removed prior to surgery. Interim lining materials may be added to the revised prosthesis at the time of surgery to improve adaptation. Definitive obturation Three to 4 months after surgery consideration may be given to the construction of a definitive obturator prosthesis. The timing will vary depending on the size of the defect, the prognosis of healing align, the prognosis for tumor control, the effectiveness of the present obturator, and the presence or absence of teeth. The detect must be engaged more aggressively for edentulous patients to maximize support, retention and stability. Therefore, the recovery period is often extended for these patients. As with conventional immediate dentures, changes associated with healing and remodeling will continue to occur in the border areas of the defect for at least l year. However in contrast with immediate dentures, dimensional changes are primarily related to the peripheral soft tissues rather than to bony support areas. By this time the mental outlook of most patients will have improved. They realize that speech, mastication and deglutition will not be compromised significantly. Most dentulous patients are prepared physically and emotionally for the extensive restorative procedures that may be required prior to the construction of a definitive obturator. In addition to treatment planning associated with a standard prosthodontic evaluation, the clinician should elicit information relative to the prognosis for tumor control and the general health and desires of the patient. A patient' s poor prognosis www.51lunwen.orgor poor health does not preclude the construction of a definitive obturator prosthesis, but the treatment plan should reflect the possible altered needs of such a patient. Mounted diagnostic casts are essential, and new radiograghs of questionable teeth should be ob留学作业定做tained. The evaluation should include opinions from the surgeon, the radiation therapist, and the clinical social worker. Most patients will be functioning well with their surgical prosthesis, so the treatment plan may be developed systematically and thoroughly. VOCABULARY l. Maxillofacial rehabilitation
  2. obturation
  3. obturator
  4. immediate surgical obturator
  5. maxillectomy
  6. surgical packing
  7. contamination
  8. nasogastric
  9. nasogastric tube 颌面修复 充填,填塞,闭塞 人工口盖,堵塞器 额护板 上颌骨切除术 外科填塞物 污染,污染物 鼻胃的 鼻胃管留学作业定做

  10. psychologic
  11. psychologic impact
  12. soft reline materials
  13. stainless steel wire
  14. resection
  15. flange
心理学的 心理影响 软衬材料 不锈钢丝 切除(术) 翼
 

相关内容

考研英语阅读文章来源

   考研英语阅读文章来源 历年考研英语阅读都是考研学子们为之苦战的项目, 为了备战考研英语, 数不清的考研 学子从做题到研究历年真题, 好不辛苦。 考研教育网为了使广大考研学子能够更加有效复习 考研,将整理的考研英语阅读理解文章来源进行整理,供参考。 一、文章来源规律 1、经济类文章主要来源 The Economist (经济学家),Business Week (商业周刊),Wall Street Journal(华尔街杂志)。 2、科学技术类文章主要来源 Nature (自然),Discove ...

数学专业英语翻译

   第一段翻译(2): what is the exact value of the number pai?a mathematician made an experiment in order to find his own estimation of the number pai.in his experiment,he used an old bicycle wheel of diameter 63.7cm.he marked the point on the tire where the ...

汽车专业英语词典

   A 进口汽车维修技术缩略语词典 *C *F *D* *N* *P* *P* O2 2WD 4WD 4WS A A A A A.I.R. A.M. A/C A/C A/CL A/CL-CWM A-post, A-pillar Amperes *Amper *Ammeter *Advance Air Injection Reactor Above-Mentioned Air Conditioning A/C Amplifie A/C Clutch Air Cleaner Air Cleaner ...

19.专业英语阅读

   专业英语阅读(电子) 课程编号: 00500680 课程名称:专业英语阅读(电子) 英文名称:Professional English Reading 总 学 时:32 总 学 分:2 适用对象: 电子科学与技术专业本科生 先修课程:《大学英语》,《半导体物理》,《半导体器件》,《半导体集成电路设计与制造》, 《半导体集成电路设计》. 一,课程性质,目的和任务 扩大学生专业词汇量,掌握英语在科技运用方面常用的语法知识,使学生完成从大学英语基础阶 段到专业英语学习阶段的过渡,能够泛读科普文章, ...

每天英语口语阅读

   十句电影台词彻底搞定面试官 1、“There is no certainty, only opportunity.”V for Vendetta (2005) - V (Hugo Weaving)没有一定会怎样,只有可能会怎样。--《V 字仇杀队》 ,V(雨果-威明) 2、“A good plan today is better than a perfect plan tomorrow.” Wag the Dog (1997) - Conrad Brean (Robert De Niro) ...

中考英语复习: 难度较大的阅读文章含答案(六)

   学英语,练听力,上听力课堂! 学英语,练听力,上听力课堂! A Debate on the English Language A measure declaring English the national language is under intense debate in the United States.The US Senate passed two declarations last week.One calls English the nation's official la ...

英语阅读

   阅读下面的短文,根据有关内容回答问题. ( 每小题 2 分 ) Everyone knows there's not enough land in Hong Kong. If you go there by air, you will arrive at Kai Tak Airport. This was built out into the sea. It is in the part of Hong Kong called Kowloon. Kowloon is one of the t ...

英语阅读

   阅读能力提高的途径    一、分析文章的结构规律   一般来说,我们阅读文章的目的是为了获取信息。文章体裁不同,其结构特点就会各异。因此,我们获取信息的最有效方法之一就是去学习和了解文章的结构,以便更加准确、快速地定位我们要找的信息。   大学英语四级考试中的阅读理解文章的体裁主要有三类:叙述文、说明文和议论文。下面我们结合2000年12月份的大学英语四级考试真题来具体说明如何利用文章的结构特点来达到阅读的目的。   1、叙述文   叙述文一般以讲述个人生活经历为主,对于经历的陈述通常由一 ...

英语阅读

   17句搞定考研英语作文 所谓万能这个概念,如果大家都去这么用的话,就等于没有用了。PartB部分是有的,但是partA没有,PartB可以基本上把这个文章全写完的一个模板方式。万能模板,你这么想,大家告诉我,只要一个题目能够转变成一社会现象之后,最好准备两到三套大的万能无敌模式。 关于万能模式的几个问题: 一、我们选用的句子的灵活性强,经过了精心的选择 二、句型都是五星级,并在开头和长短句子方面有设计,并注意语法的丰富,每句话语法都不同. 三、我们选的句子与市面的任何资料都不同 四 ...

专业英语翻译

   CHAPTER 12 Capacity and Level-of-Service Analysis for Freeways and Multilane Highways 12 章 对多车道公路和高速公路的通行能力和水平式服务的分析 12.1 Introduction to Capacity and Level-of-Service Concepts 12.1 介绍通行能力和水平式服务的概念 One of the most critical needs in traffic engineer ...

热门内容

2010年中考英语作文预测

   www.ygjj.com 阳光家教网 www.ygjj.com 2010 年中考英语作文预测(含分类) 年中考英语作文预测(含分类) 突发事件问题(热点) 突发事件问题(热点) 突发事件问题是中考书面表达的热点话题, 从非典到雪灾, 从地震到 突发事件问题是中考书面表达的热点话题, 从非典到雪灾, 甲型 HINI 流感病例(A/HINI flu cases),都频频出现在各地中考 流感病例( cases),都频频出现在各地中考 ), 试卷中,因此必须重视.但这类文章的写作有一定的难度,掌握基 ...

北京2010年中考英语试卷

   北京 2010 年中考英语试卷 听力部分略: 四,单项填空 21. Tom and Mike are good friends. often help each others. A. They B. Them C. Their D. Theirs 22. Some volunteers from Beijing arrived in Shanghai April 29 to work for the World Expo. A. on B. at C. of D. to 23. The re ...

英语(2)期末考试形式

   1 英语( )期末考试形式 考试形式: 英语(2)期末考试形式: 英语( ) 英语(2) Part One Listening Comprehension (听力 10 分) Section A : Dialogue 5 questions Section B: Passage 5 Questions Part Two Reading Comprehension (阅读 4 passages,40 分) , Part Three Vocabulary and Structure(词汇与结构 ...

2002年高考英语满分作文10篇

   2002 年高考英语满分作文(十篇) 作文题目 最近,你校同学正在参加某英文报组织的一场讨论。讨论的主题是:公园要不 要收门票?请你根据下表所提供的信息,给报社写一封信,客观地介绍讨论情况。 60%的同学认为 1.不应该收门票 2 公园是公众休闲的地方 40%的同学认为 1. 应收门票, 但票价 不要太高 3l 如收门票,需建大门、围墙, 2. 支付园林工人工资 会影响城市形象 3.购新花木 注意:1.信的开头已为你写好。 2.词数:100 左右。 3.参考词汇:门票entrance fee ...

新编大学英语3课后填空及翻译

   1.1The people were urged to do their very best to save their nation. The mountain climbers halted for a rest. I am sorry to bother you, but could you direct me to the station? She was embarrassed to heat her husband talking so loudly at the party. ...