A 58-year-old female patient had undergone segmental mandibulectomy, bilateral radical neck dissection and mandibular reconstruction with a scapular osteocutaneous flap after radiotherapy for a malignant tumor of the right lower gingiva with bilateral cervical lymph node metastasis.
As there were limitations on tongue movement and lip-closing after the operation, oral rehabilitation for dysphagia and lip-closing had been carried out, but this was not sufficient to recover from these dysfunctions. She had also undergone plastic surgery for alveolar ridge augmentation and tongue extension with skin graft, tongue extension and removal of the metal plate in the mentum region.
Then she was introduced to our clinic for fabricating a dento-maxillary prosthesis. As the shape of the lower right alveolar ridge had been obviously changed, we planned to fabricate a dento-maxillary prosthesis using the flange technique.
After impression-making and bite-taking, the denture space was made with soft plate wax for the flange technique. Then, lower artificial teeth were arranged in the denture space and functional gum festooning was done. The prosthesis was placed in harmony with the movements of the tongue and surrounding muscles. By using this method, the prosthesis stabilized adequately and the patient’s satisfaction was improved.
