Prosthodontic management of postsurgical soft tissue deformities associated with marginal mandibulectomy. Part I: Loss of the vestibule

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

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.

Prosthetic rehabilitation of a marginally resected mandibular arch with a metal reinforced telescopic overdenture

Success of the prosthesis after mandibular resection is related directly to the amount of the remaining bone and soft tissue present. The prognosis for mandibulectomy patients becomes less favorable as the size of the resection increases. Prosthetic rehabilitation for such patients is a challenge for clinicians. Without preprosthetic reconstructive surgery, denture fabrication for mandibulectomy patients becomes extremely difficult. Telescopic dentures is a modality of treatment consisting of an inner or primary telescopic coping which is permanently cemented to an abutment and an outer or secondary telescopic coping which is attached to the prosthesis. These copings protect the abutment from dental caries and thermal irritations and also provide retention and stabilization of the secondary coping. The secondary coping engages the primary copings to form a telescopic unit and it provides retention and stability to the prosthesis. This clinical report aims at utilizing the remaining natural teeth for a mandibular overdenture with telescopic coping.

Prosthodontic rehabilitation of patient with marginal mandibular resection using attachment supported prostheses: A clinical report

Marginal mandibular resection to treat neoplasms leads to loss of alveolar bone and teeth at the affected side. Consequently patient suffers with poor masticatory performance and esthetic disfigurement, which we need to restore with the help of prosthodontic rehabilitation. The success of rehabilitation of these patients depends on strategic treatment planning and choice of most suitable treatment modality. In this article, case of a patient has been presented who underwent marginal mandibular resection and reported with many limiting factors like obliterated buccal and lingual sulci, attachment of lingual frenum and lower lip at the level of alveolar ridge and Macroglossia. Impression making and fabrication of a retentive prosthesis were the main challenges. Therefore, a modified impression technique was used to fabricate mandibular cast partial denture with extracoronal semi precision attachments to enhance the retention of the prosthesis.

Clinical applications of visible light-cured resin in maxillofacial prosthetics. Part II: Tray material

As an alternative to autopolymerizing acrylic resin, visible light-cured resin for custom-made impression trays is advocated. This new system facilitates chairside tray fabrication for custom-made impressions and benefits maxillofacial prosthetic patients needing intraoral or extraoral prosthetic rehabilitation.