Three Fixation Techniques of Immediate Surgical Obturators Following Maxillectomy - A Comparative Study.

Abstract

Introduction: Conventional surgical obturators are widely used despite advancements in microvascular surgery for maxillary pathologies requiring resection due to poor surgical outcome/prognosis or financial constraints. This study was conducted to compare and evaluate three different techniques of fixation of immediate surgical obturators in maxillectomy cases.

Materials and methods: The study comprises 56 maxillectomy cases performed over 33 months from January 2021 to August 2023 in Tumkur with a minimal follow-up of 3 months. The different techniques of fixation of immediate surgical obturators are compared and evaluated for duration of fabrication, intraoperative fixation, stability, post-operative function, tissue healing and biocompatibility.

Results: Peak incidence was noted in the fourth and fifth decades of life. Both genders were almost equally involved in the study. The need for maxillectomy included - infective cystic pathology, odontogenic infections, mucormycosis, sinus pathologies and T1 maxillary carcinoma. The mean duration of hospitalisation was 5.3 days. The screw-based technique was superior in most of the criteria compared, followed by clasp-based technique and the material-based technique, respectively.

Discussion: Based on the results of the study, the screw-based fixation technique offers an edge over the other two fixation techniques in terms of being trouble free for the surgeon, easy to fabricate, biocompatible and better patient quality of life. It can also be used in edentulous patients with extensive surgeries or extraoral support.