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Histological and CT scan results.
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T3N0M0 (Figure 1). The patient had no experience about removable complete prosthesis rehabilitation.
Preoperative views of the patient with severe limitation of oral aperture. (a) Frontal view; (b) side view.
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Sectional special mandibular tray. (a) Under side view (soft wax); (b) upper side view (autopolymerizing resin).
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Hence, the choice was made to fabricate a mandibular sectional impression tray for each half of the arch by manually molding soft wax to the ridge, intraorally (Figure 3(a)). Then, the sectional special trays were reinforced by the autopolymerizing acrylic resin extraorally (Figure 3(b)).
Primary impressions. (a) maxillary primary impression; (b) Right sectional mandibular impression; (c) left sectional mandibular impression.
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The two mandibular hemi-impressions were made separately (Figures 4(b) and 4(c)).
Final impressions. (a) Maxillary impression; (b) mandibular impression.
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Care was taken during border molding to correctly record the peripheral extension, as the vestibular depth and width were shallow (Figures 5(a) and 5(b)).
The maxillomandibular relationship record (OVD, CR). (a) Lateral view with established vertical dimension of occlusion; (b) intraoral view.
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By making the mandibular record base, as possible, shorter and thinner and with patient cooperation, jaw relation record was obtained with the use of occlusion rims oriented to the established vertical dimension of occlusion, the anatomic occlusal plane, and the patient's centric relation (Figure 6(a)). The mandibular wax occlusal rim thus obtained was very short because of the reduction of the vertical prosthetic space which complicated the teeth arrangement (Figure 6(b)).
Teeth arrangement and try-in. (a) Teeth size reshaping; (b) teeth formula reduction (1 premolar and 1 molar); (c) right view; (d) left view; (e) try-in.
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(a) Final dentures; (b) frontal view of the patient after insertion.
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After bench cooling, the dentures were finished and polished (Figure 8(a)). At the insertion appointment, the balanced occlusion was adjusted (Figure 8(b)).
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Preoperative view of the patient. (a) Frontal view; (b) maximal mouth opening.
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She had extremely unuseful maxillary complete denture (Figure 9(a)). Her lips were stretched, and she had a limited oral opening with a diameter and circumference of approximately 27 mm and 98 mm, respectively, resulting from cervical radiotherapy (Figure 9(b)).
Maxillary preliminary impression. (a) First step of primary impression with putty silicon material; (b) second step of primary impression with light silicone material; (c) primary maxillary cast.
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Left impression tray segment.
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The two segments of the tray are joined using nick and notches (Figure 11).
Final impression treatments. (a) Joined sectional maxillary impression; (b) maxillary impression coffrage; (c) maxillary impression pouring; (d) maxillary final cast; (e) mandibular final impression; (f) mandibular impression coffrage; (g) mandibular final cast.
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The acrylic resin halves were carefully joined extraorally, and minor discrepancies at the seam were filled with soft impression wax (Figure 12(a)).
Occlusal record. (a) Lateral view with established vertical dimension of occlusion; (b) extraoral view.
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Teeth arrangement. (a) Maxillary view; (b) mandibular view; (c) lateral view.
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The postoperative view of the patient rehabilitated with a set of functional and esthetic complete dentures.
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The patient was provided with instructions for cleaning, inserting, and removing the prostheses (Figure 15).
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