Removable Partial Prosthesis (RPP) with acrylic resin flange for the mandibular guidance therapy

Abstract

Objectives Patients undergoing hemimandibulectomy suffer from mandibular deviation. The purpose of this article is to describe a new therapeutic possibility for the prosthetic management of these patients using only one device both for physiotherapy and eating. Methods A 56-year-old man's pre-existing mandibular removable partial prosthesis was modified to use as a partial prosthesis as a device to correct mandibular deviation. In fact, two precision attachments patrix were inserted into buccal surface of partial prosthesis base and corresponding matrix were inserted into a transparent acrylic resin guide-flange. Results In this way the patient can use only one prosthesis both for physiotherapy and eating simply inserting and removing the guide flange. The transparent resin employ is important for the day by day use. Conclusion This technique permits to use only one device both for mechanical correction of mandibular deviation and masticatory function while literature shows that two different devices are usually used in patients with mandibular deviation to satisfy both these functions.

Correction of Deviation of a Partially Resected Mandible Using a Palatal Ramp with the Aid of a Semi‐Adjustable Articulator

“…Guidance therapy is to be initiated at the earliest chance and aims to reestablish the correct path of closure for the remaining segment of the mandible. This results in an appropriate stable and functional occlusal relationship on the nonsurgical side in due course of time …”

“…Disabilities resulting from such resections may include impaired speech articulation, difficulty in swallowing, problems with mastication, altered mandibular movements, compromised control of salivary secretions, and severe cosmetic disfigurement . Restoring the continuity of the mandible with osseous and soft tissue free flaps is a recommended philosophy and aims at maintaining the balance and symmetry of mandibular function …”

“…Establishing an appropriate stable and functional occlusal relationship on the nonsurgical side is the primary focus of prosthetic rehabilitation . A well‐organized mandibular exercise regimen to be followed by the patient is initiated usually 2 weeks postsurgery followed by mandibular guidance therapy on an interim basis …”

“…Guidance prostheses to aid in correction of the mandibular deviation are of two basic types: (1) mandibular‐based guidance prostheses (or guiding flange prostheses) and (2) palatally based guidance prostheses (or palatal ramp prostheses). The palatal ramp prosthesis is preferred over the former for correction of a greater degree of mandibular deviation …”

Mandibulectomy: deviation as its sequealae and prosthodontic rehabilitation

“…Mandibular based guidance prostheses (or guiding flange prostheses) (GFP) 2. Palatally based guidance prostheses (or palatal ramp prostheses) (Prencipe, 2009) Palatal ramp prosthesis is based on the principle of inclined plane, and guides the mandibular teeth into occlusion. On the other hand in GFP, the buccal surface and the cusps of maxillary teeth make contact with the flange which generates a pulling force on the mandible guiding the jaw in desired relation.…”