Pharyngeal Obturator Prosthesis Ideal for Orthodontic Appliances: A Case Series

Abstract

(1) Background: Cleft lip and palate is the most common congenital malformation of the head and neck. After surgical closure, velopharyngeal dysfunction can arise, which has implications for phonation, sucking, swallowing, middle ear function, and interpersonal well-being. This case series aimed to present an adaptation of the conventional pharyngeal obturator design in order to allow its use with fixed orthodontic appliances. (2) Methods: A new custom-made pharyngeal obturator device was built in order to enable a correct function of the velopharyngeal valve. The fabrication of the plate was made by altering the conventional Hawley retainer, replacing the Adams hooks with 0.9 mm spherical hooks and removing the buccal arch. (3) Results: The new pharyngeal obturator design was used in six cleft patients with fixed orthodontic appliances. The appliance was well tolerated and there was a slight improvement in auditory-perceptive evaluations. (4) Conclusions: The new pharyngeal bulb design proved to have good retention during fixed orthodontic treatment. Moreover, despite the short-term follow-up, it also showed a reduction in the severity of the hypernasality sentences.

Keywords

• cleft palate
• orofacial cleft
• velopharyngeal insufficiency
• velopharyngeal dysfunctional
• orthodontics