Rehabilitation of hemimaxillectomy defects with prosthetic obturator can be challenging in term of providing adequate retention, support and stability to the prosthesis and expected outcome. Nasal reflux and hypernasal voice are the two major sequel after surgery that can affect patient social involvement and can have great psychological impact. The prosthodontist is limited by the properties of the materials available for facial restorations, the mobility of soft tissue surrounding the defects, the difficulty of establishing retention for large prosthesis, and the patient ability to accept the outcome. The outcome of prosthesis can be improved remarkably due to better coordination between surgeon and prosthodontist and careful designing of prosthesis. Dramatic improvement in the acceptance of prosthesis is seen if the prosthodontist participation can begin early in the course of patient care which ultimately will increase the quality of life (QOL) of the patient.
Oral rehabilitation of partially edentulous arches requires careful treatment planning before any prosthodontic intervention. The connection of the metal framework of fixed (fixed dental prosthesis (FPD)) and removable partial denture using adhesive attachments is a good alternative prosthetic option when solely fixed prosthesis (FPD or implant) cannot be used due to anatomical limitation. Attachments are the tiny interlocking devices that act as a hybrid link to join removable prosthesis to the abutment and direct the masticatory forces along the long axis of the abutment. This joint acts as a non-rigid stress breaker, which helps in distributing the occlusal load. Precision and semiprecision attachment have always been bordered by an aura of mystery due to technique sensitive procedure and lack of knowledge. The following case describes a combined contemporary and conventional approach and treatment sequence with the use of attachments for the rehabilitation of partially edentulous arches.
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