The prosthodontic rehabilitation of a hemimandibulectomy patient

Across Europe, Hungary ranks first in the incidence and the prevalence of oral cancers, which are usually detected in a relatively late stage. Consequently, major resective surgeries are often the only final solution. Due to the complexity of restoration, a multi-disciplinary team approach with clos...

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Main Authors: Bálint Jász, János König, Tamás Déri, László Kádár, Péter Hermann, Szandra Körmendi
Format: Article
Language:English
Published: Hungarian Dental Association 2023-03-01
Series:Fogorvosi Szemle
Subjects:
Online Access:https://ojs.mtak.hu/index.php/fogorv-szemle/article/view/10074
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author Bálint Jász
János König
Tamás Déri
László Kádár
Péter Hermann
Szandra Körmendi
author_facet Bálint Jász
János König
Tamás Déri
László Kádár
Péter Hermann
Szandra Körmendi
author_sort Bálint Jász
collection DOAJ
description Across Europe, Hungary ranks first in the incidence and the prevalence of oral cancers, which are usually detected in a relatively late stage. Consequently, major resective surgeries are often the only final solution. Due to the complexity of restoration, a multi-disciplinary team approach with close interaction amongst several health science disciplines is required, in which dentist’s contribution is crucial. Maxillofacial prosthodontics, which deals with rehabilitation of patients with deficit and defects of jaws and surrounded soft tissue, is a less known specialty of dentistry. Unfortunately those patients are scarcely referred to these specialists. Yet, as the number of affected patients in Hungary is significantly higher than a European average, such patient’s care requires complex treatment planning and creativity to deliver a custom made, individual solution. This case report presents a review of a successful solution to patient rehabilitation following a mandibular segment resection. Following the resection, several deficiencies caused by the absence of the segment, required compensation. In order to achieve normal function and aesthetics Normally, lack of masticatory muscles attachment causing severe malocclusion and a strong deflection during the opening could be compensated with either a double denture or a removable prosthesis with a guiding flange. In this case report, the latter solution is presented. After a successful completion of the mandibular resection and the prosthodontic treatment planning, the lower and upper dentures were prepared simultaneously. A combined, fixed and partially removable denture with a palatal ramp was devised for the upper jaw. For the lower jaw, a removable partial denture with a guiding flange was fabricated. After the first two steps,- preparation and impression taking – an extremely challenging registration of the lower-upper jaw relationship was performed, which was repeated several times using different set of tools. Subsequently, the guiding flange and the palatal ramp were constructed and individualized. During the insertion, the occlusion and the proper function of the guiding flange were checked. As a result, completed upper and lower dentures functioned properly, resulting in the patient’s satisfaction with the final outcome. During the short and the long-term recalls only minor corrections were performed
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spelling doaj.art-5105ac39fae94d26b558dc31f20a6ac82023-03-21T20:41:07ZengHungarian Dental AssociationFogorvosi Szemle2498-81702023-03-011161152410.33891/FSZ.116.1.15-2410074The prosthodontic rehabilitation of a hemimandibulectomy patientBálint Jász0János König1Tamás Déri2László Kádár3Péter Hermann4Szandra Körmendi5Semmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestSemmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestSemmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestSemmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestSemmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestSemmelweis Egyetem, Fogorvostudományi Kar, Fogpótlástani Klinika, BudapestAcross Europe, Hungary ranks first in the incidence and the prevalence of oral cancers, which are usually detected in a relatively late stage. Consequently, major resective surgeries are often the only final solution. Due to the complexity of restoration, a multi-disciplinary team approach with close interaction amongst several health science disciplines is required, in which dentist’s contribution is crucial. Maxillofacial prosthodontics, which deals with rehabilitation of patients with deficit and defects of jaws and surrounded soft tissue, is a less known specialty of dentistry. Unfortunately those patients are scarcely referred to these specialists. Yet, as the number of affected patients in Hungary is significantly higher than a European average, such patient’s care requires complex treatment planning and creativity to deliver a custom made, individual solution. This case report presents a review of a successful solution to patient rehabilitation following a mandibular segment resection. Following the resection, several deficiencies caused by the absence of the segment, required compensation. In order to achieve normal function and aesthetics Normally, lack of masticatory muscles attachment causing severe malocclusion and a strong deflection during the opening could be compensated with either a double denture or a removable prosthesis with a guiding flange. In this case report, the latter solution is presented. After a successful completion of the mandibular resection and the prosthodontic treatment planning, the lower and upper dentures were prepared simultaneously. A combined, fixed and partially removable denture with a palatal ramp was devised for the upper jaw. For the lower jaw, a removable partial denture with a guiding flange was fabricated. After the first two steps,- preparation and impression taking – an extremely challenging registration of the lower-upper jaw relationship was performed, which was repeated several times using different set of tools. Subsequently, the guiding flange and the palatal ramp were constructed and individualized. During the insertion, the occlusion and the proper function of the guiding flange were checked. As a result, completed upper and lower dentures functioned properly, resulting in the patient’s satisfaction with the final outcome. During the short and the long-term recalls only minor corrections were performedhttps://ojs.mtak.hu/index.php/fogorv-szemle/article/view/10074jaw relation recorddental prosthesis designguiding flangepalatal ramp
spellingShingle Bálint Jász
János König
Tamás Déri
László Kádár
Péter Hermann
Szandra Körmendi
The prosthodontic rehabilitation of a hemimandibulectomy patient
Fogorvosi Szemle
jaw relation record
dental prosthesis design
guiding flange
palatal ramp
title The prosthodontic rehabilitation of a hemimandibulectomy patient
title_full The prosthodontic rehabilitation of a hemimandibulectomy patient
title_fullStr The prosthodontic rehabilitation of a hemimandibulectomy patient
title_full_unstemmed The prosthodontic rehabilitation of a hemimandibulectomy patient
title_short The prosthodontic rehabilitation of a hemimandibulectomy patient
title_sort prosthodontic rehabilitation of a hemimandibulectomy patient
topic jaw relation record
dental prosthesis design
guiding flange
palatal ramp
url https://ojs.mtak.hu/index.php/fogorv-szemle/article/view/10074
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