Maxillectomy Rehabilitation: A Stepwise Clinical Management Timeline

For dental surgeons and prosthodontists, the success of maxillectomy rehabilitation depends not only on surgical precision but also on the timing and design of each prosthetic phase. Each stage—surgical, interim, and definitive—plays a pivotal role in restoring essential functions like speech, mastication, and swallowing, while also supporting emotional and social reintegration. 

A coordinated approach among surgeons, prosthodontists, and speech therapists can make rehabilitation smoother and outcomes more predictable. 

Timeline at a Glance: Clinical Workflow Snapshot 

Preoperative Planning and Coordination 

The preoperative phase forms the cornerstone of maxillectomy rehabilitation. Early assessment enables prosthodontists to visualize the expected defect, design the surgical obturator, and prepare impressions and casts before surgery. 

Preserving as much hard palate as possible ensures better retention, support, and stability for the future prosthesis. Collaboration between the surgical and prosthodontic teams ensures that resection margins and prosthetic planning align perfectly for seamless postoperative care.¹  

Immediate Phase: Surgical Obturator Placement 

A surgical obturator is placed either immediately during surgery or within the first postoperative week. 

Clinical Benefits 

• Protects and supports the surgical site 

• Facilitates early speech and swallowing 

• Enhances healing and shortens hospital stay 

• Reduces psychological distress caused by facial changes 

Pro Tip: Early involvement of the prosthodontist during surgery allows precise adaptation and faster patient recovery.² 

Interim Phase: Adapting to Healing 

Within 3 to 4 weeks, when tissue remodeling begins, an interim obturator is fabricated. This temporary prosthesis accommodates ongoing changes in the surgical site and restores essential functions.³ 

Clinical Benefits 

• Restores oral function and comfort 

• Improves clarity of speech and swallowing 

• Provides emotional reassurance and boosts social confidence 

Pro Tip: Keep the design simple yet retentive. Avoid overextension to prevent irritation and encourage daily wear compliance. ⁵ 

Definitive Phase: Long-Term Restoration 

Once healing is complete—usually around 3 to 4 months, post-surgery—a definitive obturator is fabricated. This phase focuses on long-term stability, function, and aesthetics. ³ 

Clinical Benefits 

• Maximizes mastication efficiency 

• Improves resonance and speech clarity 

• Enhances facial symmetry and overall quality of life 

Pro Tip: Incorporate a cast metal framework with a full palatal connector to ensure durability, optimal stress distribution, and superior retention.⁶ 

Case Snapshot: Phased Rehabilitation in Practice 

A 34-year-old patient who underwent partial maxillectomy was rehabilitated through a structured three-phase process. 

1. Immediate obturator placed during surgery supported healing and enabled early speech. 

2. Interim obturator fabricated after 3 weeks was modified periodically for comfort and function. 

3. Definitive obturator created after full healing restored long-term oral efficiency and aesthetics.⁷ 

This sequential approach improved not only oral functionality but also the patient’s psychological resilience and social reintegration.⁷ 

Final Thought 

Patients recovering from maxillectomy often face significant physical and emotional challenges, difficulty speaking, eating, and altered facial appearance can deeply impact confidence. 

A team-based approach, guided by precise prosthodontic planning and timely rehabilitation, transforms the recovery process. With each stage carefully executed, patients regain not just oral function but also a sense of normalcy and self-esteem. 

Reference 

1. Prakash P, Bhandari SK. Maxillectomy-surgical resection and prosthodontic rehabilitation. IP Ann Prosthodont Restor Dent. 2021;7:72-8. 
2. Mohamed K, Subhiksha R, Preetha K. Pre-emptive designing of immediate surgical obturator. Indian Journal of Surgical Oncology. 2021 Dec;12(4):745-9. 
3. Dalkiz M, Dalkiz AS. The effect of immediate obturator reconstruction after radical maxillary resections on speech and other functions. Dentistry journal. 2018 Jun 21;6(3):22. 
4. Goyal C, Goyal R. Rehabilitation of Maxillary Defect with an Interim Obturator: A Case Report. 
5. Jadhava M, Tembhurne J. Interim obturator in maxillectomy patient. Integr J Med Sci. 2024;10(3 Pt A). doi:10.22271/oral.2024.v10.i3a.1980. 
6. Farghal AE. Fabrication of a definitive obturator for a patient with a maxillary defect: a case report. Cureus. 2023 Dec 15;15(12):e50578. 
7. Ouaalla M, El Assraoui K, Zeroual R, Bellemkhannate S. Rehabilitation of a patient with partial maxillectomy: A Case Report. Integrative Journal of Medical Sciences. 2021 Dec 14;9.