Kathleen Manuela D’Souza

Abstract

Various techniques have been described to restore acquired maxillary defects. The aim of this paper is to review the contemporary treatment modalities that have been explored to rehabilitate and reconstruct partial or complete maxillectomy in dentulous and edentulous patients. MEDLINE/PUBMED search was conducted for dental literature published from January 2000 to December 2018. Literature study revealed various methods and materials used to treat patients with acquired maxillary defects. These include modifications in method and materials used for the fabrication of conventional obturators (using precision and semi-precision attachments, telescopic copings, magnets, silicone based materials, titanium and its alloys, PEEK, thermoplastic resin); implant-supported obturators supported on conventional, zygomatic and pterygoid implants using different attachments (ERA, magnet, bar attachment, locator, ball attachment); use of CAD/CAM technology for presurgical planning and fabrication of obturator prosthesis; surgical reconstruction with microvascular free tissue flaps; and bone engineering. Significant attention has been devoted to refining current methods and developing better methods to successfully rehabilitate maxillectomy patients. The use of osseointegrated implants, newer prosthesis materials, advanced laboratory procedures, inclusion of CAD/CAM technology, advances in surgical reconstructive techniques and tissue engineering has revolutionized the traditional treatment options. Keywords: Maxillectomy, Implants in maxillectomy, Microvascular free flap, Bone tissue engineering.

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Abstract

Eating disorders (EDs) are psychosocial conditions having a significant impact on the patient’s general and oral health status. Since dentists are usually the first health professionals to encounter patients with EDs, it is important to be aware of the characteristic presentations of these disorders. This narrative review aims to provide a knowledge base for restoring dentists about three main eating disorders –Anorexia nervosa, Bulimia nervosa and Binge Eating Disorders, their systemic and oral manifestations, protocol for preventive care and comprehensive treatment plan. Literature search was conducted in electronic databases and 60 articles were selected for the review. Considerable emphasis is placed on diagnosis and management of such disorders. These patients pose a challenging situation to the dental fraternity, since most restoring dentists are unaware of the fundamental importance of their role in the multidisciplinary treatment and due to lack of training regarding strategies involved in their dental treatment.   Keywords: Eating disorders, Oral manifestations, Diagnosis, Prosthodontic management.

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