PMC6340086_01
Armany Class VI maxillary defect
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F1
A 50-year-old male presented to the Department of Prosthodontics and Implantology with partial maxillary edentulism, a history of uncontrolled diabetes, and a mucormycosis infection which resulted in resection of the hard palate, leading to an Aramany Class VI maxillary defect [Figure 1].
Two-piece magnetic acrylic obturator
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F2
On intraoral examination, he presented with an abrasion on the inferior turbinate within the defect due to the existing prosthesis, which was a rigid, two-piece, magnetic acrylic obturator [Figure 2].
Primary impression
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F3
Final impression
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F4
Computer-aided design of the obturator bulb
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F5
A contemporary three-dimensional (3D) design technique [Figure 5] was considered rather than the conventional wax-up to facilitate a holistic analysis of the final prosthesis.
Definitive cast, trial obturator bulb in poly(methyl methacrylate), titanium framework
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F6
Further, the designed obturator bulb was milled in a poly (methyl methacrylate) (PMMA) material [Figure 6] before final fabrication to facilitate a definitive trial in the patient's mouth.
Three-dimensional printed castable framework
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F7
Once the trial was approved, the designed prosthetic components were printed in a castable material (Juell 3D UV resin) [Figure 7] using a 3D printing machine (O3D Orchestrate), invested and casted in Class 1 pure titanium using a vacuum pressure casting system (Titec F205M, OROTIG).
Laser welding of the titanium bulb and framework
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F8
The titanium components were polished and laser welded (LASER Welder, EVO 125) [Figure 8] together, hence providing a complete hollow-bulb titanium framework [Figure 9].
Titanium bulb laser welded to the titanium framework. Note 5 orientation grooves and circumferential undercut for retention
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F9
The titanium components were polished and laser welded (LASER Welder, EVO 125) [Figure 8] together, hence providing a complete hollow-bulb titanium framework [Figure 9].
Trial placement of the obturator
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F10
Inner surface of the flexible, removable silicone cap showing orientation and retention locks
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F11
Outer surface of the flexible, removable silicone cap which engages the defect undercuts
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F12