The guidance flange prosthesis helps in directing the deviating mandible to improve form and function. This case report describes a procedure. Mandibular Guide Flange Prosthesis Following Mandibular Resection: A Clinical Report. SHAILENDRA KUMAR SAHU*. MDS, Senior Lecturer, Dept. of. prosthesis.2 In a mandibular-based guidance prosthesis, the guide flange is attached to a mandibular removable partial denture (RPD) on the nonresected side.

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Ann Maxillofac Surg ;5: The use of mandibular guidance prosthesis to correct mandibular deviation following hemimnadibulectomy – Case reports. J Maxillofac Oral Surg. Hence preoperative casts should be advocated for all patients so that exact maxillo-mandibular relationship can be obtained postoperatively.

Upon opening the mouth, this deviation increases, leading to the opening and closing of the angular pathway. Please review our privacy policy. Maxillary GF guice the choice as the loss of mandibular canine results in more downward rotation of mandible and the mandibular GF might not be stable. Rehabilitating dentulous hemimandibulectomy patients. A 19 gauge hard, round, stainless steel orthodontic wire was manipulated to fabricate C clasps on the first premolars and first molars on both the sides of the maxillary cast.

Definitive guiding flange prosthesis: A definitive approach in segmental mandibulectomy defect

Published online Sep All authors equally contributed to the treatment and writing case report. A 49 years old male patient presented to the hospital with the complaint of difficulty in mastication and facial disfigurement for the past guidd years owing to carcinoma left buccal mucosa for which he underwent composite resection of mandible and reconstructed with Pectoralis major myocutaneous flap following preoperative chemotherapy and radiotherapy.

The earlier the mandibular guidance therapy is initiated in the course of treatment; the guie successful is the patient’s definitive occlusal relationship. Rehabilitation of a long-standing segmental mandibulectomy case without any early intervention is a challenging task, especially due to the lack of bony support and loss of muscle co-ordination.


Guide flange prosthesis for early management of reconstructed hemimandibulectomy: a case report

The lingual flange extension on the entire lingual surfaces of the three teeth and deep in the lingual sulcus also helps increasing the stability of the prosthesis. The more the mandible remaining, the better is the prosthetic prognosis. The presence of the teeth in both the arches is important for the effective guidance and the reprogramming of the mandibular movements. Patient was able to bring remaining mandible to centric occlusion with guidance and he was not able to achieve this position consistently.

Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years.

If this influence is uncompensated, the contraction of cicatricial tissue will fix the residual fragment in its deviated mandibuular 5 ]. Temporary retainers can be made preoperatively so that it can immediately placed after surgery[ 8 ]. Prosthetic rehabilitation following segmental mandibulectomy.

Intraoral view showing loss of alveolar ridge on left side with vestibular obliteration Arrows showing thick freely movable tissues and note the deviation of the mandible. I hope guidf collaboration with JCDR will continue for a long time”.

A 17 year old girl was referred to the Department of Prosthodontics Government Dental College and Hospital, Nagpur, Maharashtra, India for prosthetic rehabilitation following a hemi-mandibulectomy reconstructed with FFF.

A definitive cast partial denture with a metal guiding flange and acrylic teeth was planned. During this initial healing period early prosthodontic intervention by mandibular guide flange and maxillary stabilization prosthesis serve the purpose of reducing the mandibular deviation, preventing extrusion of the maxillary teeth and improving the masticatory efficiency. However, the most prevalent indication that requires surgical resection of the mandible along with the involved adjacent oral structures is the presence of a locally aggressive neoplastic growth.


Three days after insertion of the prosthesis, the patient was able to achieve a functional intercuspal position without manual manipulation. In spite of all the factors that were of concern for the success of guidance therapy, the factors that helped us to achieve the desired outcome were the patient motivation, remaining of tongue, floor of the mouth, and its contiguous soft tissues.

Ishiyaku Euro America; Mandibular guidance prostheses following resection procedures: The purpose of occlusal extensions on maxillary left posteriors was to prevent the extrusion of the teeth because of missing opposing mandibular teeth. On the basis of clinical and radiographic examination, the patient was classified as Class III substantially compromised according to prosthodontic diagnostic index resources for partial edentulous patients described by McGarry et al.

Prosthfsis examination revealed thick, freely movable soft tissues with scar formation, loss of alveolar ridge and obliteration of buccal and lingual sulci in the left half of mandibular region distal to left lateral incisor Fig.

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Definitive guiding flange prosthesis: A definitive approach in segmental mandibulectomy defect

Also, the access statistics of the articles are available. The time of initiation of the treatment is the key to success for restoring the form and flsnge. Occlusal considerations for the partial mandibulectomy patient.