Prosthesis for mandibular guidance therapy – A case series

Abstract

This article shows the importance of an intra-oral guiding flange prosthesis in patients who have undergone resection of mandible due to an underlying pathology. The case series show how the use of a guidance prosthesis can re-educate the mandibular muscles and re-establish an occlusal relationship for the resected mandible. Fabrication of a Guiding flange prosthesis was done for patient's reporting to the department of Prosthodontics, with a significant deviation of mandible causing a deranged occlusion. Utilisation of various intra-oral prosthesis designs to overcome the deranged forces of the mandibular muscles have been shown. Basic designs used for fabricating the guidance prosthesis were buccal-based (maxillary based), palatal-based (maxillary based) and mandibular-based guidance. The re-establishment of the occlusal relationship was successful with the use, of any of the basic designs, of a guiding prosthesis. The patients could maintain a healthy occlusal relationship even after cessation of the therapy. This case series gives an insight as to how a Guidance prosthesis can be utilized either on an interim basis or as a part of definitive treatment too, although the success depends on the nature of surgical defect, patient's cooperation and early physiotherapy program.