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ould not be established on the defect side until the surgical wound is well organized. If the patient is scheduled for a total maxillectomy with resection to the midline, the three maxillary anterior teeth included in the resection may be added to the prosthesis to improve esthetics.
     6. In some patients the existing complete or partial prosthesis may be adapted for use as an immediate surgical obturator. However, the arrange of the prosthesis corresponding to the proposed defect should be reduced and the posterior denture teeth removed prior to surgery. Interim lining materials may be added to the revised prosthesis at the time of surgery to improve adaptation.
     Definitive obturation
     Three to 4 months after surgery consideration may be given to the construction of a definitive obturator prosthesis. The timing will vary depending on the size of the defect, the prognosis of healing align, th留学作业定做e prognosis for tumor control, the effectiveness of the present obturator, and the presence or absence of teeth. The detect must be engaged more aggressively for edentulous patients to maximize support, retention and stability. Therefore, the recovery period is often extended for these patients. As with conventional immediate dentures, changes associated with healing and remodeling will continue to occur in the border areas of the defect for at least l year.
     However in contrast with immediate dentures, dimensional changes are primarily related to the peripheral soft tissues rather than to bony support areas. By this time the mental outlook of most patients will have improved. They realize that speech, mastication and deglutition will not be compromised significantly. Most dentulous patients are prepared physically and emotionally for the extensive restorative procedures that may be required prior to the construction of a definitive obturator.
     In addition to treatment planning associated with a standard prosthodontic evaluation, the clinician should elicit information relative to the prognosis for tumor control and the general health and desires of the patient. A patient' s poor prognosis or poor health does not preclude the construction of a definitive obturator prosthesis, but the treatment plan should reflect the possible altered needs of such a patient. Mounted diagnostic casts are essential, and new radiograghs of questionable teeth should be obtained. The evaluation should include opinions from the surgeon, the radiation therapist, and the clinical social worker. Most patients will be functioning well with their surgical prosthesis, so the treatment plan may be developed systematically and thoroughly.

VOCABULARY

l. Maxillofacial rehabilitation 颌面修复
2. obturation 充填、填塞、闭塞
3. obturator 人工口盖、堵塞器
4. immediate surgical obturator 额护板
5. maxillectomy 上颌骨切除术
6. surgical packing 外科填塞物
7. contamination 污染、污染物
8. nasogastric 鼻胃的留学作业定做
9. nasogastric tube 鼻胃管
10. psychologic 心理学的
11. psychologic impact 心理影响
12. soft reline materials 软衬材料
13. stainless steel wire 不锈钢丝
14. resection 切除(术)
15. flange 翼