Guiding Flange Prosthesis for a patient with mandibular deviation following Hemimandibulectomy defect: A Case Report

Prosthesis for mandibular guidance therapy – A case series

“…2 The degree of deviation depends on the location, extension of the resection and the amount of soft tissue involvement. 3 This deviation is more evident in edentulous situations than in dentulous patients who can give good inter-cuspation. 4 This shift is attributed to the uncompensated influence of the contra-lateral musculature, particularly the internal pterygoid muscle and the pull of the cicatricial tissue on the resected side.…”

“…5 Two features dictate the uncoordinated action of the residual mandibular segment, Firstly, the remaining unilateral muscular activity is specific to the surgical resection and has a characteristic resting posture to the defect side with a diagonal movement on closure; Secondly, as healing progresses the surgical environment changes, and the patient's efforts to train movement during this healing period will help to maintain both position and movement range. 3 A corrective device known as 'guide flange prosthesis' is indicated to limit this clinical manifestation and enable the movement during the healing period. 1 A guide flange prosthesis is used primarily as an interim training device.…”

“…1 A guide flange prosthesis is used primarily as an interim training device. 3 In the past many modalities have been used which includes inter-maxillary fixations, vacuum formed PVC splints, guide flange prosthesis and a widened maxillary occlusal table with twin occlusion. 5 Inter-maxillary fixation maintains the residual bone in the proper maxillo-mandibular position at the time of surgery but only works well when the discontinuity defects are small because the soft tissue is available to close the defects.…”