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Reabilitação oral pós-cirurgia maxilo-facial : papel das próteses obturadoras
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A reabilitação dos defeitos maxilares após cirurgia maxilo-facial representa um desafio funcional, protético e psicossocial, particularmente quando existe comunicação oro-nasal ou oro-antral. Este trabalho tem como objetivo analisar o papel das próteses obturadoras na reabilitação oral destes doentes, considerando as suas indicações, princípios de conceção, fases clínicas, resultados e limites. A literatura analisada mostra que os obturadores podem contribuir para melhorar a fala, a deglutição, a mastigação, o conforto, a estética e a qualidade de vida, desde que exista uma adaptação protética adequada e um acompanhamento clínico regular. A previsibilidade da reabilitação depende de fatores como a extensão do defeito, a retenção disponível, a estabilidade da prótese, a qualidade dos tecidos, a presença de dentes remanescentes e a capacidade de manutenção a longo prazo. A comparação com alternativas reconstrutivas ou implanto-retidas evidencia que a escolha terapêutica deve ser individualizada e orientada pelas características anatómicas, funcionais e sistémicas de cada doente. Assim, a prótese obturadora permanece uma opção reabilitadora relevante, desde que integrada numa abordagem multidisciplinar e centrada no doente.
Rehabilitation of maxillary defects after maxillofacial surgery represents a functional, prosthetic and psychosocial challenge, particularly when an oro-nasal or oro-antral communication is present. This work aims to analyse the role of obturator prostheses in the oral rehabilitation of these patients, considering their indications, design principles, clinical phases, outcomes and limitations. The literature reviewed shows that obturators can contribute to improving speech, swallowing, mastication, comfort, aesthetics and quality of life, provided that adequate prosthetic adaptation and regular clinical follow-up are ensured. The predictability of rehabilitation depends on factors such as the extent of the defect, available retention, prosthetic stability, tissue quality, the presence of remaining teeth and the patient’s ability to maintain the prosthesis in the long term. Comparison with reconstructive or implant-retained alternatives shows that therapeutic decision-making should be individualized and guided by the anatomical, functional and systemic characteristics of each patient. Therefore, the obturator prosthesis remains a relevant rehabilitative option, provided that it is integrated into a multidisciplinary and patient-centred approach.
Rehabilitation of maxillary defects after maxillofacial surgery represents a functional, prosthetic and psychosocial challenge, particularly when an oro-nasal or oro-antral communication is present. This work aims to analyse the role of obturator prostheses in the oral rehabilitation of these patients, considering their indications, design principles, clinical phases, outcomes and limitations. The literature reviewed shows that obturators can contribute to improving speech, swallowing, mastication, comfort, aesthetics and quality of life, provided that adequate prosthetic adaptation and regular clinical follow-up are ensured. The predictability of rehabilitation depends on factors such as the extent of the defect, available retention, prosthetic stability, tissue quality, the presence of remaining teeth and the patient’s ability to maintain the prosthesis in the long term. Comparison with reconstructive or implant-retained alternatives shows that therapeutic decision-making should be individualized and guided by the anatomical, functional and systemic characteristics of each patient. Therefore, the obturator prosthesis remains a relevant rehabilitative option, provided that it is integrated into a multidisciplinary and patient-centred approach.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Prótese obturadora Maxilectomia Reabilitação oral Defeitos maxilares Qualidade de vida