A Digital Method For Split Maxillary Interim Obturators Fabrication.

The maxillary interim obturator is a short-term maxillofacial prosthesis for patients post-partial maxillectomy, restoring esthetics and function. Since deep cavities are often present in the maxillary defect area, fabrication of custom trays is necessary. Esthetic and functional reconstruction is not achieved until the patient's third visit in the routine process. The digital fabrication of split maxillary interim obturators achieves improved esthetics during the second visit while reducing 3D printing material waste. A 72-year-old man presented with an oronasal communication defect in the premaxillary region. After intraoral scanning, CAD software was used to design the 3 components with attachment systems of the obturator: a defect-specific custom tray, denture base and artificial teeth. 3D-printed denture base, teeth and wrought wire clasps were cemented in place. During the second visit, the custom tray was waxed onto the denture base to obtain a final impression of the defective cavity before removed. Then left the rest in the mouth to restore esthetics. During the third visit, the definitive defect module (designed based on the assembly structure and the final impression) was cemented, achieving functional reconstruction validated via drinking water and voice tests. Although the split obturator resulted in an earlier esthetic recovery, the assembly structure requires attention to designing proper clearance, or it may lead to difficulty in impression. The method proposed in this case not only saves the material used to 3D print complete custom trays, but also restores the patient's esthetics earlier than conventional solutions.