case_images: PMC6340086_01
case_images: Armany Class VI maxillary defect
case_images: JIPS-19-74-g001.jpg
case_images: PMC6340086_01_JIPS-19-74-g001.jpg
case_images: F1
case_images: 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].
case_images: Two-piece magnetic acrylic obturator
case_images: JIPS-19-74-g002.jpg
case_images: PMC6340086_01_JIPS-19-74-g002.jpg
case_images: F2
case_images: 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].
case_images: Primary impression
case_images: JIPS-19-74-g003.jpg
case_images: PMC6340086_01_JIPS-19-74-g003.jpg
case_images: F3
case_images: Final impression
case_images: JIPS-19-74-g004.jpg
case_images: PMC6340086_01_JIPS-19-74-g004.jpg
case_images: F4
case_images: Computer-aided design of the obturator bulb
case_images: JIPS-19-74-g005.jpg
case_images: PMC6340086_01_JIPS-19-74-g005.jpg
case_images: F5
case_images: 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.
case_images: Definitive cast, trial obturator bulb in poly(methyl methacrylate), titanium framework
case_images: JIPS-19-74-g006.jpg
case_images: PMC6340086_01_JIPS-19-74-g006.jpg
case_images: F6
case_images: 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.
case_images: Three-dimensional printed castable framework
case_images: JIPS-19-74-g007.jpg
case_images: PMC6340086_01_JIPS-19-74-g007.jpg
case_images: F7
case_images: 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).
case_images: Laser welding of the titanium bulb and framework
case_images: JIPS-19-74-g008.jpg
case_images: PMC6340086_01_JIPS-19-74-g008.jpg
case_images: F8
case_images: 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].
case_images: Titanium bulb laser welded to the titanium framework. Note 5 orientation grooves and circumferential undercut for retention
case_images: JIPS-19-74-g009.jpg
case_images: PMC6340086_01_JIPS-19-74-g009.jpg
case_images: F9
case_images: 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].
case_images: Trial placement of the obturator
case_images: JIPS-19-74-g010.jpg
case_images: PMC6340086_01_JIPS-19-74-g010.jpg
case_images: F10
case_images: Inner surface of the flexible, removable silicone cap showing orientation and retention locks
case_images: JIPS-19-74-g011.jpg
case_images: PMC6340086_01_JIPS-19-74-g011.jpg
case_images: F11
case_images: Outer surface of the flexible, removable silicone cap which engages the defect undercuts
case_images: JIPS-19-74-g012.jpg
case_images: PMC6340086_01_JIPS-19-74-g012.jpg
case_images: F12