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Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery.

Bhattacharya SR, Majumdar D, Singh DK, Islam MD, Ray PK, Saha N - Contemp Clin Dent (2015)

Bottom Line: Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site.Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration.This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry, R. G. Kar Medical College, Kolkata, West Bengal, India.

ABSTRACT
Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

No MeSH data available.


Related in: MedlinePlus

Occlusion achieved with the prosthesis in place at maximum intercuspation (lateral view)
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Figure 3: Occlusion achieved with the prosthesis in place at maximum intercuspation (lateral view)

Mentions: Primary maxillary and mandibular impressions were made with alginate and poured with dental stone. Both the cast are mounted using bite registration record. After mounting of the mandibular cast it was observed that the buccal surface of the mandibular teeth were almost 8 mm lingual to the palatal surface of the maxillary palatal cusps [Figure 1]. Modeling wax was added to cover the palate. On this, additional wax was added on the left side of the prosthesis towards the palatal surface. The thickness of the wax was determined by the position of the mandibular teeth. C Clasp is placed on the 24 for retention. The whole pattern was invested, dewaxing done and heat cure acrylic was packed and processed. The patient was recalled and the maxillary prosthesis was inserted and checked for retention and stability. The prosthesis is then modified to act as guidance prosthesis by the addition of self-cure acrylic resin to form a ramp or guide plane palatal to the maxillary teeth opposing the nonresected portion of the mandible [Figure 2]. The ramp directs mandibular teeth into intercuspal position on closing. With the aid the patient can achieve consistent closure to an intercuspal postion [Figure 3]. The prosthesis was inserted and patient was given instruction regarding the maintenance of the prosthesis and was put on a regular follow-up.


Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery.

Bhattacharya SR, Majumdar D, Singh DK, Islam MD, Ray PK, Saha N - Contemp Clin Dent (2015)

Occlusion achieved with the prosthesis in place at maximum intercuspation (lateral view)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374305&req=5

Figure 3: Occlusion achieved with the prosthesis in place at maximum intercuspation (lateral view)
Mentions: Primary maxillary and mandibular impressions were made with alginate and poured with dental stone. Both the cast are mounted using bite registration record. After mounting of the mandibular cast it was observed that the buccal surface of the mandibular teeth were almost 8 mm lingual to the palatal surface of the maxillary palatal cusps [Figure 1]. Modeling wax was added to cover the palate. On this, additional wax was added on the left side of the prosthesis towards the palatal surface. The thickness of the wax was determined by the position of the mandibular teeth. C Clasp is placed on the 24 for retention. The whole pattern was invested, dewaxing done and heat cure acrylic was packed and processed. The patient was recalled and the maxillary prosthesis was inserted and checked for retention and stability. The prosthesis is then modified to act as guidance prosthesis by the addition of self-cure acrylic resin to form a ramp or guide plane palatal to the maxillary teeth opposing the nonresected portion of the mandible [Figure 2]. The ramp directs mandibular teeth into intercuspal position on closing. With the aid the patient can achieve consistent closure to an intercuspal postion [Figure 3]. The prosthesis was inserted and patient was given instruction regarding the maintenance of the prosthesis and was put on a regular follow-up.

Bottom Line: Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site.Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration.This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry, R. G. Kar Medical College, Kolkata, West Bengal, India.

ABSTRACT
Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

No MeSH data available.


Related in: MedlinePlus