Fabrication of a hollow-bulb obturator

Kenneth E. Brown, Commander (DC) USN*

Dental Department, U. S. Naval Hospital, Great Lakes, Ill.

W hen a dentist is called upon to supply a prosthesis for a patient who has had
a maxillary resection, he must use every possible mechanical advantage. The total
weight of the appliance is a most important consideration, especially when the
obturator has a cantilever suspension, The laboratory procedures used to fabricate
a hollow-bulb obturator are familiar to technicians with maxillofacial prosthetic
background. The purpose of this article is to describe the technical procedures for
making hollow-bulb obturators.

IMPRESSIONS
Make a master cast from an impression made in a custom tray. Always carry
the impression laterally, posteriorly, and superiorly to include shelf-like supporting
areas for increased retention (Fig. 1) .

JAW RELATION RECORDS

1. Record centric relation, and mount the casts on an articulator with the use
of a face-bow.
2. Arrange the teeth and try-in setup for esthetics.
3. Complete the final wax-up of the maxillary denture.

PREPARATION FOR FORMING THE PATTERN OF THE OBTURATOR

1. Complete the wax-up of the defect.
2. Place a layer of tinfoil over the surface of the defect, and fold it to create a
divider at the midline between the obturator and the remainder of the appliance.

INVESTING FOR ONE HALF OF THE OBTURATOR

1. Invest the maxillary denture in the lower half of the flask.
2. Set the upper half of the flask in position on the lower half.

The opinions or assertions contained herein are. the private ones of the author and are not
to be construed as official or reflecting the views of the Navy Department or the Naval Service
at large.
*Formerly Fellow in Prosthodontics, Maxillofacial area, University of Texas Dental
Branch, M. D. Anderson Hospital Tumor Institute, Houston, Texas.

97
 J. Pros. Dent.
98 Brown January, 1969

Fig. 1. A cross-section illustrates the extensive dimensions of an obturator to adequately seal

and gain support of an orbital-maxillary defert.

Wax divider
/--- ----
/

Defect side

Fig. 2. The obturator is half-flasked with the upper collar in place. The wax divider is shown
placed to isoIate the arch overlying th? region of the defect.
 Fabrication of an obturator 99

Fig. 3. The tinfoiled area over the obturator is completely flasked in stone, and a thin matrix
of stone has been placed over the remaining arch.

Fig. 4. The tlask is immersed in a water bath on its side with the defect area down to con-
centrate heat on the defect and not on the remaining wax-up.
100 Brown J. Pros. Dent.
January, 1969

----_-- ---_

__- _ __

Fig. 5. The teeth and the wax contour of the obturator remain in the upper half of the flask
when separated from the lower flask.

Fig. 6. A cross-section of the inverted upper original flask rompletely flasked by pouring stone
through the opening of the lower flask plate
Volume
Number
21
1
Fabrication of an obturator 101

J
Fig. 7. A cross-section of the full flasking of the defect and the maxillary waxed denture.
Additional wax has been added to the defect for strength and for elimination of undercuts.

3. Place a wax divider in the upper half of the flask between the defect and the
maxillary denture (Fig. 2).
4. Fill the region of the defect in the upper jaw in the upper half of the flask
with stone.
5. When the stone has set, remove the wax divider.
6. Paint a thin cover of stone over the exposed wax surface of the maxillary
denture. Keep the stone away from the wall of the flask (Fig. 3).
7. Immerse the flasked denture in a hot-water bath with the defect facing down-
ward into the water. Heat will be concentrated on the defect side softening this wax
before the remainder of the maxillary denture wax-up has a chance to be softened
(Fig. 4).
8. When the wax has softened, remove from the water bath, and separate the
two halves of the flask. To prevent the stone matrix from separating from the
lower half of the flask, use a downward pressure with a finger on the stone matrix
during the separating technique (Fig. 5).
9. Invert the upper half of the flask and contour the remaining wax to a thick-
ness that will give rigidity and strength to the processed acrylic-resin obturator.
10. Lubricate the walls of the unfilled part of the flask, and fill the chamber with
plaster.
11. Place a new lower half of a flask on the original upper half of the flask.
Remove plate from inside of the lower half of the new flask before fitting to the
upper half.
12. Pour plaster through the hole in the lower half of the flask to complete the
flasking (Fig. 6).
102 Brown J. Pros. Dent.
January, 1969

Fig. 8. The relationship of the processed section created by the assrmbly of the original flasks.

Fig. 9. The completed obturator with a hollow charnbvr.

IS. Boil out the ilasked assembly. and thorou&ly cleanse the inside of the
flask.
11,. Pack acrylic into the clcanstd flask, and proct~ss in the usual manner.
15. Separate the two halvrs of thcx flask. & sure to keep the processed acrylic
in the upper half of thr original flask.

INVESTING FOR THE SECOND HALF OF THE OBTURATOR

1. Remove the base plate and the cxccss wax from the defrct in the lower half
of the original flask. Allow sufficient was to remain in the walls of the defect: or
add wax if necessary. to Tive strength and rieiclity to the processed acrylic.
2. Place a new upper half of a flask over thr lower half of the original flask.
z%&:’ Fabrication of an obturator 103

3. Pour stone into the upper half of the flask, and fill completely (Fig. 7).
4. Place the flask in the water bath to soften the wax.
5. Separate the heated flask, remove the wax, and thoroughly cleanse the in-
side of both halves of the flask.
6. Pack the flask with acrylic resin and process.
7. Remove the upper half of the flask. Exercise extreme care SO that the pro-
cessed acrylic remains in the original lower half of the flask.

JOINING THE TWO HALVES OF THE PROCESSED OBTURATOR TOGETHER

1. Roughen the exposed surfaces of the acrylic resin in both halves of the flask
to insure good bonding (Fig. 8).
2. Place a layer of autopolymerizing resin over the exposed surfaces of the
obturator in each half of the flask.
3. Close the two halves of the flask together, and hold under pressure until
the resin is cured.
4. Deflask the entire assembly.
5. Trim and polish the denture and the completed obturator with the hollow
bulb (Fig. 9).

SUMMARY
A technical description of the fabrication of a hollow-bulb obturator is pre-
sented. In an attempt to improve the retentive and stabilizing characteristics of an
obturative prosthesis, an outline of the technical construction is proposed which
reduces the total weigth of the appliance by processing two separate sections and
creating a hollow inner chamber.
DENTAL DEPARTMENT
U. S. NAVAL HOSPITAL
GREAT LAKES, ILL. 60088