Dynesthetic Rehabilitation to Minimize Mandibular Deviation for a Patient Following Segmental Resection

Aggressive intraosseous lesions obliterate structures, including maxilla and mandible, which may require surgical management followed by prosthetic rehabilitation. Loss of continuity of the mandible destroys the balance and symmetry of the mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Prosthetic management of surgical defects has always been a challenge for a prosthodontist. A thorough knowledge of post surgical anatomy and physiology is a prerequisite for the development of a successful prosthesis. Numerous prosthetic methods are employed to minimize deviation and improve masticatory efficiency which includes implant supported prosthesis, mandibular guide flange prosthesis and palatal based guidance restoration. This case report describes prosthodontic management of a patient who had undergone segmental mandibular resection with palatally oriented guidance (palatal ramp) prosthesis. The prosthesis helped the patient guide the mandible to facial symmetry which served the purpose of aesthetics and to hold the mandible in position without deviating to the surgical site during speech and mastication.