J Adv Prosthodont.  2011 Sep;3(3):172-176. 10.4047/jap.2011.3.3.172.

Guide flange prosthesis for early management of reconstructed hemimandibulectomy: a case report

• Patil PG
• Patil SP

• KMID: 2118128
• DOI: http://doi.org/10.4047/jap.2011.3.3.172

Abstract

Surgical resection of the mandible due to presence of benign or malignant tumor is the most common cause of the mandibular deviation. Depending upon the location and extent of the tumor in the mandible, various surgical treatment modalities like marginal, segmental, hemi, subtotal, or total mandibulectomy can be performed. The clinicians must wait for extensive period of time for completion of healing and acceptance of the osseous graft before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes early prosthodontic management of a patient who has undergone a reconstructed hemi-mandibulectomy with modified mandibular guide flange prosthesis. The prosthesis helps patient moving the mandible normally without deviation during functions like speech and mastication.

Keyword

Ameloblastoma; Dental prosthesis design; Fibula free-flap; Mandibular prosthesis; Maxillofacial prosthesis; Segmental mandibulectomy

MeSH Terms

Ameloblastoma
Dental Prosthesis Design
Humans
Mandible
Mandibular Osteotomy
Mandibular Prosthesis
Mastication
Maxillofacial Prosthesis
Moving and Lifting Patients
Prostheses and Implants
Prosthodontics
Transplants

Figure

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  Fig. 1 Pre-operative panoramic radiograph showing extensive radiolucent area in left mandible, B: Post-surgical panoramic radiograph showing reconstructed left mandible with osseous graft.

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  Fig. 2 Intraoral view showing loss of alveolar ridge on left side with vestibular obliteration. Note arrows indicating thick freely movable soft tissues. Note the deviation of the mandible on defect (left) side on opening.

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  Fig. 3 A: Wire substructure: occlusal view, B: Wire substructure: buccal view.

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  Fig. 4 Completed modified guide flange prosthesis. Note arrows indicating the buccal indentations of opposing maxillary teeth in occlusion to guide the mandible in a definite closing point.

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  Fig. 5 Completed maxillary stabilization plate.

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  Fig. 6 A: Prosthesis in place during large mouth opening. Note occlusal extensions of the maxillary stabilization plate on right posteriors, B: Prosthesis during mandibular movements, C: Prosthesis guided the mandible in a definite closing point.

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