Marginal mandibulectomy involves resection of mandibular body with overlying soft tissues while maintaining inferior cortex of mandible and its continuity. It may lead to numerous problems associated with mastication, speech and deglutition and esthetics. Problems associated with such defect depend upon location and extent of surgical resection. Prosthodontic rehabilitation of such patient poses challenges because of obliterated vestibular depth, inadequate denture bearing areas for support, lesser number of remaining teeth. This article describes rehabilitation of patient who underwent anterior segmental mandibulectomy with cast partial removable denture to replace the missing teeth and maintain esthetics
With the advancement in science and technology, Immediate implant placement has become a widely used and well accepted alternative to traditional treatment protocols. Post extraction implant placement in multicoated molar area is challenging. The primary stability in molar areas is achieved by engaging the interradicular bone but slipping of osteotomy drill to mesial or distal root socket during implant bed preparation is the main problem in post extraction immediate implant placement. Use of surgical guide, pre- extractive interradicular implant bed preparation and the combination of both these techniques has been used to overcome the problem related to immediate implant placement at molar sites. This paper presents an alternative approach in immediate Implant placement in multi rooted molar area that uses the anatomy and morphology of roots in guiding the osteotomy to provide an ideal3-dimensional implant positioning.
The placement of implant following removal of compromised tooth is a common practice. Hard and soft tissue changes following tooth extraction, particularly on the labial aspect are known to occur. These changes compromise aesthetics, particularly in anterior maxilla leading to esthetic failure. Socket shield technique is known to prevent resorption of buccal bone, maintaining contour of buccal mucosa and achieving better result aesthetically. The purpose of this case report is to demonstrate the socket shield technique for immediate implant placement in anterior maxilla and restoration with cement retained prosthesis.
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