JOURNAL OF PROSTHETIC DENTISTRY THE

Vol. 101 No. 2      February - 2009

ISSN: 0022-3913      UBIC: 171

RESUMEN

Patients with a diagnosis of mucosal malignant melanoma involving the maxilla or paranasal sinuses requiring surgery are referred to the maxillofacial prosthodontist for treatment. The standard protocol of surgical, interim, and definitive obturator treatment is usually anticipated. Depending upon the stage and presence or absence of metastasis, it is gnerally accepted that the prognosis for cure of this disease is poor. This clinical report reviews the current literature regarding treatment and the overall guarded prognosis for this disease, and reports the prosthodontic treatment intervention for 8 patients. Prosthodontic treatment strategies are recommended that are consistent with the reality of the diagnosis to achieve optimal function and quality of life for these patients. (J Prosthet Dent 2009; 101:85-91)

SUMMARY

The aggressive biologic behavior of the oral and/or sinonasal mucosal malignant melanoma and its poor survival outcome have been documented in this report. Medical treatment and survival outcomes reviewed in this study are consistent with what has been reported in the literature. Prosthodontic treatment for patients requiring partial maxillectomy or palatectomy may include the standard protocol of surgical, interim, and definitive obturator treatment. A high percentage of patients may not survive long enough to receive a definitive obturator or could be involved in medical treatments for an extended period of time before a definitive obturator can be made. Consequently, emphasis should be given to the design of the interim obturator, since it may have to remain in function for a prolonged period of time and may be the definitive prosthesis. Treatment plans that are conservative, flexible, and address the needs of this group of patients are encouraged. Although the prognosis for the disease may be poor, efforts to provide optimal function and quality of life should not be diminished and can be achieved with a realistic, pragmatic approach.

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