PMC5863394_01
(a) Mandibular deviation toward the defect. (b) Orthopantomogram showing the defect distal to the right lateral incisor. (c) Rectangular tube attached to mesh minor connector on nondefective side. (d) Cast metal rod
CCD-9-120-g001.jpg
PMC5863394_01_CCD-9-120-g001.jpg
F1
Facial asymmetry and deviation of the mandible to the reconstructed (right) side (about 10-12 mm from midline on 37 mm of mouth opening) was noted [Figure 1a]. An orthopantomogram revealed resection of the mandible distal to the right lateral incisor involving the ramus, coronoid process, and condyle [Figure 1b]. Type III dental stone (Kalstone; Kalabhai Karson, Mumbai, India). The mandibular RPD framework was designed after surveying the cast (MARATHON, Surveyor 103 Complete) and customized tube-shaped wax pattern (10 mm length; 5 mm x 5 mm square cross-section) (Alphabond Dental, BEGO wax profiles; Germany) was attached to the mesh minor connector on the nondefective side before casting [Figure 1c]. A metal rod [Figure 1d] was casted separately (12 mm length; 4 mm x 4 mm square cross section) with a U-loop at one end to retain the acrylic guiding flange (Remanium; Dentaurum GmbH and Co.
(a) Metal rod with U-loop to retain acrylic guiding flange. (b) Metal rod inserted through tube. (c) Intraoral functional molding of guiding flange. (d) Acrylic guiding flange
CCD-9-120-g002.jpg
PMC5863394_01_CCD-9-120-g002.jpg
F2
KG, Ispringen) [Figure 2a]. After insertion of the RPD, the metal rod was inserted through the tube [Figure 2b], and softened modeling plastic impression compound (DPI Pinnacle; Mumbai) was placed on the U-loop of the rod for intraoral functional molding of the guiding flange that extended laterally and superiorly up to the maxillary buccal sulcus [Figure 2c]. Subsequently, the guiding flange was flasked and processed with clear heat-activated acrylic resin (Heat Cure; DPI) [Figure 2d].
(a) Maxillary stabilization plate. (b) Detachable acrylic guiding flange retained to mandibular removable partial denture. (c) Acrylic maxillary plate covering posterior teeth. (d) Patient with guiding flange prosthesis
CCD-9-120-g003.jpg
PMC5863394_01_CCD-9-120-g003.jpg
F3
This maxillary stabilization plate was processed using clear acrylic resin (Heat Cure; DPI) [Figure 3a].