Prosthetic management of hemimandibulectomy patient with guiding plane and twin occlusion prosthesis

Abstract

Mandibular deviation is multifactorial defect and its severity is based on the extent of osseous and soft tissue involvement, degree of tongue impaired, the loss of sensory and motor innervations, the type of wound closure, the presence of remaining natural teeth and finally the first initiation of prosthetic treatment. We describe a case of prosthetic management of a maxillary partially edentulous patient with hemimandibulectomy who reported after 4 years of postsurgical cancer therapy. A simple maxillary guided hollow inclined plane with twin occlusion acrylic prosthesis was fabricated as a functional training device to correct mandibular deviation, restore maxillomandibular relation and occlusal approximation. The patient was able to functionally achieve good maxillomandibular occlusal approximation with guidance therapy combined with physiotherapy in 2 weeks. A 6 months follow-up revealed patient satisfactory appreciation by understanding the limitations of overall prosthetic rehabilitation.

Prevention and treatment of maxillo-mandibular disorders following an interrupted mandibulectomy: The role of guide flange prosthesis

“…The functional disorders are more or less important depending on the quantity of soft tissue and bone resected, the site of the loss of substance, the degree of loss of motor and sensory innervation, the degree of lingual dysfunction, the number and quality of the lost and residual teeth, the wound closure technique and finally the moment of the beginning of the treatment [9].…”

Immediate prosthetic rehabilitation of marginal mandibulectomy post radiation case by single-piece implant - A case report

“…When the force of closure increases, the residual mandible actually rotates through the frontal plane. [ 34 ] The medial pterygoid muscle and mylohyoid muscles; a part of masticatory muscles; always pull the mandible toward the resected side, thus misbalancing the equilibrium of masseter and medial pterygoid muscles. The muscles of mastication are normally in a state of equilibrium when the opposing teeth are lightly touching.…”

Mandibularezekált páciens protetikai ellátása

“…Ezen pótlások előnye, hogy viszonylag könnyen, rövid idő alatt elkészíthetőek, nem igényelnek erős elhorgonyzást (fogatlan állcsont esetén is alkalmazhatóak) és olcsóbbak. Hátrányuk viszont, hogy az ép ízület és az izmok egy kóros pozícióban maradnak, illetve a dupla fogsor miatt a nyelvteret jelentősen szűkítik [7,8].…”