Rehabilitation of Aramany Classification I Defect on a Completely Edentulous Patient: A Clinical Case Report.

Abstract

This clinical case report describes a prosthetic rehabilitation for a patient who had partial maxillectomy surgery following the diagnosis of maxillary squamous cell carcinoma in 1991. She was also previously diagnosed with parotid gland pathology on the right and required complete removal of gland along with facial nerve. Her previous prosthesis is 18 years old and claims it not as retentive as before. Intraorally there was a large oval shaped defect on the right side of the maxilla sparing the left alveolus. Defect extends more than 2/3rd of the palatal area with communication to the nasal floor. Presence of buccal frenal pull on the right side on the upper and lower jaws due to the wound contracture on that side of the face. The extraoral facial asymmetry and weakness of facial muscles in this patient may lead to improper denture border seal of the prosthesis. Patient was provided with maxillary acrylic obturator and mandibular acrylic complete denture as a definitive treatment with careful denture extension planning. She was reviewed multiple times till prosthesis stability intraorally was achieved. This improved the prognosis for this patient. The only option for retaining prosthesis in this case, without implants, is optimum engagement of the available soft-tissue undercuts found within the defect space and the non-affected side. Keywords: Completely Edentulous, Obturator, Facial Nerve, Prognosis, Case Report.