Pravinkumar G Patil1. 1. Department of Prosthodontics, Government Dental College & Hospital, GMC Campus, Medical Square, Nagpur 440003, Maharashtra, India.
Abstract
PATIENT: A patient who had undergone left segmental mandibulectomy reconstructed with an autogenous bone graft presented with the chief complaint of difficulty in eating and speaking. Intraoral examination revealed thick, freely movable soft tissues with scar formation, loss of alveolar ridge, and obliteration of buccal and lingual sulcus in the entire left half of mandibular region. When given the options of pre-prosthetic surgery and dental implants, patient refused to undergo an additional surgery and requested a non-surgical treatment option. Consequently, conventional complete denture therapy modified by neutral zone technique was undertaken. DISCUSSION: Prosthetic rehabilitation of this patient was challenging due to inadequate amount of supporting tissues on the defect side resulting from cancer surgery. The fabrication procedure of the denture was carefully modified to achieve retention and stability. Tissue surface of the denture was relined with resilient liner, polished surface contours and tooth positioning were recorded with neutral zone technique and occlusal surfaces were modified to achieve balanced occlusion. CONCLUSION: Conventional complete denture therapy with carefully recorded intaglio surface, cameo surface, and balanced occlusal surface can provide favorable retention and stability even though the denture bearing tissues are unfavorable especially in segmental mandibulectomy patients.
PATIENT: A patient who had undergone left segmental mandibulectomy reconstructed with an autogenous bone graft presented with the chief complaint of difficulty in eating and speaking. Intraoral examination revealed thick, freely movable soft tissues with scar formation, loss of alveolar ridge, and obliteration of buccal and lingual sulcus in the entire left half of mandibular region. When given the options of pre-prosthetic surgery and dental implants, patient refused to undergo an additional surgery and requested a non-surgical treatment option. Consequently, conventional complete denture therapy modified by neutral zone technique was undertaken. DISCUSSION: Prosthetic rehabilitation of this patient was challenging due to inadequate amount of supporting tissues on the defect side resulting from cancer surgery. The fabrication procedure of the denture was carefully modified to achieve retention and stability. Tissue surface of the denture was relined with resilient liner, polished surface contours and tooth positioning were recorded with neutral zone technique and occlusal surfaces were modified to achieve balanced occlusion. CONCLUSION: Conventional complete denture therapy with carefully recorded intaglio surface, cameo surface, and balanced occlusal surface can provide favorable retention and stability even though the denture bearing tissues are unfavorable especially in segmental mandibulectomy patients.
Authors: Marcelo Coelho Goiato; Rodrigo Antonio de Medeiros; Aljomar José Vechiato Filho; Emily Vivianne Freitas da Silva; Mariana Vilela Sônego; Karina Helga Turcio de Carvalho; Aimée Maria Guiotti; Stefan Fiuza de Carvalho Dekon; Aldiéris Alves Pesqueira; Daniela Micheline Dos Santos Journal: Ann Med Surg (Lond) Date: 2015-05-16