Hello Colleen,

Although I have worked on obturators with zygomatic implants, I have yet to recommend this type of treatment to one of my patients. Thankfully, most of the patients that I have treated only had partial maxillectomy where the remaining teeth on the other side provide satisfactory retention of the obturator. The implants retained prostheses are reserved for cases where the patient is edentulous (no teeth remaining), has recieved total maxillectomy or the remaining teeth are not suitable for clasps or attachments.

Regarding the surgical repair of the palatal defects, I cannot comment on it much because it is outside of my expertise. I have seen a case with excellent surgical repair where the defect is small however. On large maxillary defects that have multiple teeth missing, prosthetic repair makes more sense since you can use the appliance as a foundation to restore missing teeth. By the time the patients are referred to me for prosthetic reconstruction, the surgical approach is no longer a high end option.

I can tell you that it is very rare to have a surgical reconstruction of extra-oral defects such as the ear or nose that are satisfactory. All surgical recontructions I have seen in my short career so far leave lots to be desired. An implant retained prostheses I believe is the best treatment in this particular case.

Discoloration of the lateral incisor can be caused by many factors. If you have decreased saliva output, the "washing" action by the saliva is decreased thus plaque or food particles tend to accumulate and thus changing the color of the tooth. Very common in people who drink lots of coffee or tea with decreased saliva output. Medications also play a role. Peridex (oral rinse) is known to cause moderate stain on the teeth. Another cause is necrosis of the pulpal tissue inside the tooth (nerve tissues dying). Your dentist can check for the tooth vitality with some simple tests. There are more causes of tooth darkening but those mentioned are more common causes. Let me know how your visit with your dentist goes. DP