An innovative approach to the prosthodontic management of Class III mandibular defect

Abstract

Class III mandibular resection due to surgical treatment of jaw tumor produces a discontinuity in the mandible which is severely incapacitating to the patient. It leads to a deviation and rotation of the mandible which depends on the amount of tissues resected the manner of surgical site closure, loss of proprioceptive sense of occlusion, the presence, and condition of teeth, and the time of initiation of prosthodontic therapy. These put together makes the task of prosthodontic rehabilitation quite arduous. Guide flange prosthesis is a comparatively simple and cost-effective method of restoring the esthetics and function to an acceptable level. This clinical report describes an innovative and simplified approach to impression making (sectional two-step impression) to minimize trauma to the underlying and circumoral fragile tissues postsurgery, and to the fabrication of buccal guide flange (wrought wire supported and reinforced guide flange) for prosthetic rehabilitation of a patient with Class III mandibular resection.

Guidance Prostheses for Partial Mandibulectomy Patients: A Case Series

“…Restrictive MGP was designed with a flange extending 7 to 10 mm laterally and superiorly on the buccal aspect of the premolars and molars on the nondefect side. This flange engaged the maxillary teeth during mandibular closure, directing the mandible to an optimal intercuspal position [13][14][15]. The GF can be made of cast chrome-cobalt metal or acrylic resin.…”

A Systematic Review on Prosthodontic Rehabilitation of Hemimandibulectomy Defects

“…Acrylic MGFP is a cost-effective alternative with the added advantage of periodic adjustment over metal guide flange [ 24 - 26 , 30 , 31 , 33 , 34 , 36 , 39 , 40 , 42 , 55 , 57 ]. The acrylic flange during sequential adjustment becomes thin and weak; hence, reinforcing with ‘W’-shaped wrought wire is an innovative approach to overcome this drawback [ 23 ]. The twin occlusion prosthesis as given in class II situation is indicated in class II defects [ 16 , 18 ].…”

“…. The acrylic flange during sequential adjustment becomes thin and weak; hence, reinforcing with 'W'-shaped wrought wire is an innovative approach to overcome this drawback [23]. The twin occlusion prosthesis as given in class II situation is indicated in class II defects [16,18].…”