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KMID : 0362420150530010039
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Journal of Korean Academy of Prosthodontics
2015 Volume.53 No. 1 p.39 ~ p.45
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Prosthetic rehabilitation of partially edentulous patient after hemimandiblectomy: Case reportMandibular osteotomy; Neutral zone technique; Twin occlusion; Bisphosphonate-associated osteonecrosis of the Jaw
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Lee Dong-Hun
Yoo Dong-Soo
Lee Jong-Hyuk
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Abstract
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Loss of continuity of the mandible destroys the balance and symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Apart from deviation, other dysfunctions include difficulty in swallowing, speech, mandibular movements, mastication, and respiration are accompanied. In general, surgical reconstruction is considered first then proceeds to the prosthetic restorations. However, patients with systemic disease such as BRONJ (Bisphosphonate related osteonecrosis of the Jaw), surgical reconstruction may be limited. Thus, the prosthetic restoration remains as the only resort. Numerous prosthetic methods are employed to minimize deviation and to improve masticatory efficiency, function and esthetics. If a removable partial denture is the selected treatment modality, maximum stability of the partial denture base may be accomplished with a functional impression procedure by means of eliminating lateral and horizontal forces caused by the functional movements of the lips, cheeks and tongue. Also, Twin occlusion is used to obtain a favorable occlusal relationship and check support for esthetics. The purpose of this case report is to demonstrate how neutral zone impression technique and twin occlusion scheme were applied to restore a hemi-mandiblectomy patient with BRONJ syndrome to achieve satisfactory results in functional and esthetic aspects.
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KEYWORD
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Mandibular osteotomy, Neutral zone technique, Twin occlusion, Bisphosphonate-associated osteonecrosis of the Jaw
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