Dear Dr. Phan,

My husband served a year in Vietnam--1968-69--so I can relate a bit to your history. What a saga for you and your family.

I very much appreciate your writing to this site. There are not many of us who use prosthodontic devices, but there are a few, and I am one of them.

I am 15 months post surgery for a hemi maxillectomy and partial palatectomy. I have been fitted for an obturator, which is surprisingly satisfactory, though, or course, still imperfect.

I will write my questions here, since someone else might be interested, or might need the same information.

In my surgery, all teeth on the right side were removed; the first remaining tooth is the lateral incisor on that side. I lost 5 teeth (the wisdom tooth had already been removed years ago,) along with the bone and about 2/3 of the hard palate on that side.

I have received my "definitive" obturator....a "cadillac" made of metal and acrylic. We are still trying to improve the fit of the appliance, as there is some leakage and some movement.

Here is my most specific question: My prosthodontist has suggested that, since I do not have rear teeth on the surgery side, I would improve the retention of the appliance if I would have my front teeth crowned, so that a special clip could be installed on the rear side of the lateral incisor and the right central incisor. I would have to crown at least four, and possibly five teeth for a satisfactory appearance.

I hesitate to cut down good teeth, especially after having lost five good teeth already. The crowns would, of course, have to be made of porcelain over metal, and not the newer all=porcelain type.

The other option would be to get zygomatic implants. I do not have the pterygoid bone process remaining. I have consulted a specialist at Baylor Dental School in Dallas about the zygomatic implants. They sound interesting, but I haven't seriously considered them.

Do you have suggestions? My surgeon feels that I am cancer-free, and he is actually encouraging me to consider reconstructive surgery.

I am feeling a bit overwhelmed by so many options. What would your advice be?

I am so glad that you came along with your offer of advice, since I am to go to my prosthodontist on Thursday of this week.

Colleen--T-2N0M0 SCC dx'd 12/28/05...Hemi-maxillectomy, partial palatectomy, neck dissection 1/4/06....clear margins, neg. nodes....no radiation, no chemo....Cancer-free at 4 years!