GUIDE FLANGE PROSTHESIS – A SIMPLE YET EFFICIENT AID FOR SEGMENTAL MANDIBULECTOMY PATIENTS

Dr. Ashmi Sebastian, Dr. Sanjayagouda B. Patil, *Dr. Sonu Manoj Agrawal, Dr. Lakkappa Shivappa Ganiger, Dr. Shruti Ch and Dr. Sambayya Nanjannavar

ABSTRACT

Purpose: To fabricate a simple yet efficient aid, to improve condylar position, to reduce mandibular deviation and to enhance the masticatory efficiency, for a segmental mandibulectomy patient. Method: A guide flange prosthesis was fabricated without additional retentive aids to enable the patient comfort and an occlusal acrylic extension for stabilizing unopposed dentition on resected side. Heat cure PMMA (Poly methyl methacrylate) was employed for fabrication. Results: Mandibular guidance was achieved using a guide flange prosthesis fabricated on maxillary arch. Mandibular deviation was corrected to almost 4-5 cm where patient couldn’t move the mandible atleast by 2 mm. On a follow-up visit after 1 week patient reported with improved masticatory efficiency, reduced TMJ discomfort and facial profile. After 1 month follow-up, the patient could guide her non-resected side of mandible to normal occlusal relation and she was able to guide her mandible half-way to normal occlusion without the prosthesis. Conclusion: Mandibular guidance therapy in segmental mandibulectomy patients would help to establish an acceptable occlusion by re-educating the muscles and thus normal occlusion and mastication can be achieved.

Keywords: Hemimandibulectomy, Guide Flange Prosthesis, Mandibular Deviation.