Introduction
Squamous cellcarcinoma of the oral cavity is the malignant
neoplasm that makes individuals suffer both physiologically and
psychologically
Surgical resection of the tumour and the structures involved with
it along with the radiotherapy or chemotherapy is the treatment
protocol for oral squamous cell carcinoma
It is very difficult to do the prosthetic rehabilitation of such
patient especially for the mandible because the segmental loss
of mandibular integrity leads to its deviation towards the
resected area with lack of occlusion
In addition segmental loss of mandible results in limited mouth
opening
4.
Aim and Objectives
This case report deals with Cantor and Kurtis type two defect in
which mandible was resected distinctly from canine region on the
right side of the Arch
In this report the patient was rehabilitated with a double occlusal
table
5.
Cantor and Curtisdefect classification
Class 1 – Radical Alveolectomy
With preservation of
mandibular continuity
Class 2- Lateral resection of the
mandible distal to the canine
area
Class 3 – Resection of the
mandible to the midline
6.
Class 4 –Lateral resection surgically reconstructed
with bone grafts
Class 5- anterior mandibular defects with bone graft
reconstruction
Class 6- anterior man develops without surgical
reconstruction
7.
Case presentation
43years old male patient
Chief complaint- Compromised
aesthetics, difficulty in speaking, lack of
ability to chew
Extraoral examination- Mandibular
deviation on the right side compromising
the aesthetic
Intraoral examination- maxillary Kennedy
class one partially edentulous arch
Patient was habitual eating beetle nuts
for past eight years
8.
Treatment planning
Primaryimpression was made using alginate
Secondary impression was made using addition silicon
Master cast was obtained on which fabrication of Wax
occlusal rims was done
Jaw relation was performed
The retention in the presented case was provided by
the circumferential clasps on the abutment teeth 12
and 25
The two rows of semi anatomic acrylic were selected
9.
The EdentulousSpaces were replaced by first row of
anatomical teeth in the desired position and the second row
was arranged on the palatal to the first row where mandible
watch closing in a functional position
Follow up was done regularly
10.
Discussion
The rehabilitationof mandible defects are challenging
because in addition to the loss of anatomical structure there
is also loss of sensation of muscles of mastication and
occlusion
Phonetics is also important parameter in achieving normal
physiological activity of the patient
Pronunciation of various words sounds should be accurate
The benefit of this prosthesis is cost effective patient friendly
and light in weight to withstand the force of gravitation
11.
Conclusion
The rehabilitationof Hemi mandibulectomy patients with
double occasional table prosthesis its efficacious and is of
considerable importance
This report gives a productive plan to give a prosthesis in
the Maxilla when there is limited space left in the
mandibular arch
However clinical techniques complexity of the case
maintenance of the prosthesis and patient acceptance will
determine the treatment prognosis
References
1.Peres MA,Macpherson LM, Weyant RJ, et al. Oral diseases: a global public health
challenge. Lancet 2019; 394(10194): 249–260.
2. Bugshan A and Farooq I. Oral squamous cell carcinoma: metastasis, potentially
associated malignant disorders, etiology and recent advancements in diagnosis. F1000res
2020; 9: 229.
3. Yoon HI. Prosthetic rehabilitation after fibular free flap surgery of mandibular defects
in a patient with oral squamous cell carcinoma. J Craniofac Surg 2016; 27(7): e685–e688.
4. Koralakunte PR, Shamnur SN, Iynalli RV, et al. Prosthetic management of
hemimandibulectomy patient with guiding plane and twin occlusion prosthesis. J Nat Sci
Biol Med 2015; 6(2): 449–453.
5. Sampat SC, Saloni M, Parmeet B, et al. Prosthodontic rehabilitation of an edentulous
hemimandibulectomy patient. Int J Prevent Clin Dental Res 2020; 7(4): 115.
6. Sharma R, Sharma A, Verma BP, et al. Twin-occlusion prosthesis: a glimmer of hope for
hemimandibulectomy patient. Indian J Dental Sci 2019; 11(1): 61.
