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Resolution of Excessive Interocclusal Restoration Space Post-Mandibulectomy


Now online in the Journal of Prosthodontics, a case report describing the process of prosthetic rehabilitation from extensive surgical excision to final rehabilitation using a creative two-layer fixed implant prosthesis in a 70-year-old patient with oral squamous cell carcinoma.

Patients treated with segmental mandibulectomy often require complicated rehabilitation. Extreme interocclusal restoration space (>19 mm) is a common problem during reconstruction.

Although RPDs are usually employed as a treatment option, in this case, the patient desired an implant-supported fixed prosthesis to restore his chewing function. During treatment, a 3D analysis of the inter-arch space in the defect region revealed an excessive interocclusal restoration space which exceeded the length of the longest screwdriver. Limited maximum mouth opening was also noted so a two-layer prosthesis was designed to ease the placement of prosthetic screws.

This two-layer design (substructure and suprastructure) yielded better ease of insertion, improved retrievability, and favorable force distribution. After 18 months of observation, the patient showed strict adherence to oral hygiene measures, the crestal bone level of the implants remained stable, and the denture was functioning well The patient’s facial profile and mastication were successfully restored.

Lan Y-H, Yang H-Y, Chang H-H, et al: Resolution of excessive interocclusal restoration space post-mandibulectomy using a two-layer retrievable fixed implant-supported prosthesis: a case report. J Prosthodont 2022; https://doi.org/10.1111/jopr.13497


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