COMPREHENSIVE DENTISTRY

Maxillofacial Prosthetics Tertiary Care Clinic

Maxillofacial rehabilitation of patients with acquired or congenital disabilities of the head and neck region is a difficult process requiring multidisciplinary collaboration. Frequently, some form of prosthetic service is required as part of the treatment of these patients. Maxillofacial prosthetics is that discipline concerned with the prosthetic restoration of stomatognathic and associated facial structures. Indications for maxillofacial prosthetic treatment include head and neck cancer surgery, trauma to the head and neck region, and craniofacial anomalies. Maxillofacial prosthetics is important in the treatment of these conditions, as prostheses are often needed to restore oral functions such as deglutition, speech and mastication in instances where these functions are compromised. In other instances, a prosthesis may be indicated for cosmetic and psychosocial reasons. Prosthetic devices may also be used to position or shield facial structures during radiotherapy of head and neck cancer patients.

The overall goal of all maxillofacial prosthetic treatment is to improve the quality of life by reducing the morbidity associated with a treatment which benefits a particular head and neck condition. The mission of the Maxillofacial Prosthetics Tertiary Care Center is to serve as a valuable community resource for San Antonio and the South, Central and West Texas Regions by providing quality maxillofacial prosthetic support services for referring health care providers and by providing quality care for patients in need of these services. The center can help area health care providers provide the highest standard of care for their patients with head and neck conditions. The staff, which includes a medical sculptor and a maxillofacial prosthetics laboratory technician, is experienced and eager to assist patients with their treatment needs.

Most of the professional services available in the Maxillofacial Prosthetics Tertiary Care Clinic have CPT codes and are covered under Medicare, Medicaid, and private insurance plans. For additional information about the center or to refer a patient, please call (210) 567-6440.

Prosthetic Restoration of Hard Palate Defects

Prostheses Offered:

Surgical Obturators: A surgical obturator is a temporary prosthesis used to restore the continuity of the hard palate immediately after surgery or traumatic loss of a portion or all of the hard palate and/or contiguous alveolar structures. For this service, it is best that the patient be evaluated a few days before the surgery.

Service includes:

  • Delivery in the operating room
  • Unpacking of the defect
  • Maintenance and relines of the obturator

Interim Obturators: An interim obturator is a prosthesis that is made after a surgical resection of a portion or all of one or both maxilla; frequently, this may include replacement of teeth in the defect area. This prosthesis replaces the surgical obturator that is inserted immediately following the resection and is worn by the patient for months until wound healing has progresses.

Definitive Obturators: A definitive obturator is a prosthesis that artificially replaces part or all of the maxilla and associated teeth lost due to surgery or trauma. It is fabricated after complete healing of the defect has occurred.

Prosthetic Treatment of Mandibular Defects

Treatment of mandibular defects includes defects resulting from surgical resections of the mandible, tongue, or floor of mouth. 

Prostheses Offered:

Mandibular Resection Prostheses:
A mandibular resection prosthesis is a maxillary and/or mandibular prosthesis delivered after a mandibular resection to provide the remaining deviated mandibular segment improved occlusal contact with the maxillary dentition. This can require the use of a flange, guide, or occlusal platform incorporated in the prosthesis to guide the mandibular segment into optimal occlusal contact.

Mandibular Reconstruction Prostheses:
A mandibular reconstruction prosthesis is a prosthesis delivered after surgery to reconstruct continuity of the mandible following a mandibular resection.

Palatal Augmentation Prostheses:
A palatal augmentation prosthesis is a prosthesis that allows reshaping of the hard palate to improve tongue-palate contact during speech and swallowing. The prosthesis is necessary in patients with impaired tongue mobility caused by surgery, trauma, or neurological motor deficits. 

Prosthetic Restoration of Soft Palate Deficiencies

Prostheses Offered:

Speech Aid Prostheses:
A speech aid prosthesis is a removable maxillary prosthesis to restore an acquired or congenital defect of the soft palate. A portion of the prosthesis extends into the pharynx to separate the oropharynx and nasopharynx during phonation and deglutition, thereby completing the palatopharyngeal sphincter.

Palatal Lift Prostheses
A palatal lift prosthesis is a removable prosthesis that aids in velopharyngeal closure by elevating an incompetent soft palate that is dysfunctional due to clefting, surgery, trauma, or paralysis.

Prosthetic Restoration of Facial Defects

Prostheses Offered:

Auricular Prostheses:
An auricular prosthesis replaces the auricular portion of an ear that is partially or totally missing due to surgery, trauma, or a congenital anomaly.

Nasal Prostheses:
A nasal prosthesis is a prosthesis that replaces a nose that is partially or totally missing due to surgery or trauma.

Orbital Prostheses:
An orbital prosthesis is a prosthesis that replaces the contents of the orbital region, including the eyelids and the eyeball, following surgery or trauma.

Ocular Prostheses:
An ocular prosthesis is a prosthesis that replaces an eyeball following surgery or trauma.

Prosthetic Restoration of Congenital Defects

Prostheses Offered:

Prostheses for Cleft Palate and Other Craniofacial Anomalies:
These prostheses are needed to obturate a cleft or restore missing/defective dentition in patients with cleft palate or other craniofacial anomalies. Feeding aids for infants can also be fabricated.

Fabrication of Implant-Supported Maxillofacial Prostheses

Both intraoral and extraoral implant-supported maxillofacial prostheses can be fabricated.

Fabrication of Cranial Implants

A cranial implant is a biocompatible, permanently implanted replacement for a portion of the skull.

Fabrication of Radiation Stents & Carriers

Prostheses Offered:

Radiation Stents:
A radiation stent is an intraoral prosthesis designed to position/shield tissues during radiotherapy of the head and neck regions. Types of radiation stents include:

Tongue Depressing Stents:
A tongue depressing stent is a custom made device which positions the mandible and depresses the tongue during radiotherapy of head and neck tumors. These stents are more accurate and provide greater patient comfort than the commonly used "cork and tongue blade."

Balloon Bolus Supporting Stents:
A balloon bolus supporting stent supports a saline-filled balloon bolus in a maxillectomy defect during radiotherapy following a maxillectomy due to head and neck cancer. The bolus serves to improve dosimetry at the defect site. The stent also positions the mandible and depresses the tongue outside of the radiation field.

Parotid Stents:
A parotid stent contains an alloy that shields contralateral tissues during unilateral radiotherapy of the parotid gland or buccal mucosa.

Peroral Cone Positioning Stents:
A peroral cone positioning stent positions a peroral cone during radiotherapy for head and neck tumors. This type of stent is commonly used when boosting the dose to the tumor site.

Radiation Carriers:
A radiation carrier is a device used to administer radiation to confined areas by means of capsules, beads, or needles of radiation emitting materials.

Fabrication of Miscellaneous Maxillofacial Prostheses

Miscellaneous Maxillofacial Prostheses include:

Surgical Stents Surgical Mouthguards
Surgical Splints Nasal Stents
Fluoride Carriers Digital (Finger) Prostheses
Lip & Cheek Support Prostheses Athletic Facemasks
Laryngectomy Aids Facial Moulages
Tracheostomy Obturators Sleep Apnea Appliances
Orofacial Plugs Other Miscellaneous Prostheses

 

Conventional Prosthodontic Treatment

Prosthodontics is that branch of dentistry pertaining to the restoration and maintenance of oral function, comfort, appearance, and health of the patient by the restoration of natural teeth and the replacement of missing teeth with artificial substitutes. In addition to maxillofacial prosthetic services, conventional prosthodontic treatment such as crowns, bridges, dentures, and implant-supported prostheses are available at the center.

Payment for Services:

The patient, not the referring health care provider, is responsible for payment. Most services in the Maxillofacial Prosthetics Tertiary Care Center have CPT codes and are covered under Medicare, Medicaid, and private insurance plans. The Billing Department handles financial arrangements.

Referral Information:

To refer a patient to the Maxillofacial Prosthetics Tertiary Care Center, please call (210) 567-6440 between 8 a.m. and 5 p.m., Monday through Friday. Maps with directions to the center can be mailed to the patient prior to the first appointment. [Map to clinic]

Directions to Maxillofacial Prosthetics Tertiary Care Center:

The Maxillofacial Prosthetics Tertiary Care Center is located on the 4th floor of the Dental School at The University of Texas Health Science Center at San Antonio. Visitor parking for the Dental School is provided in Lot 8. There is a minimal parking fee. Enter through the front doors of the Dental School and take the elevator to the 4th floor. The entrance to the Maxillofacial Prosthetics Tertiary Care Center (Room 4.168R) is on the right side of the main 4th floor waiting area as you enter the area from the elevator foyer. Go into the Maxillofacial Prosthetics Tertiary Care Center reception area and check in with the receptionist. If you have any questions, please call the center at 567-6440.