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Journal of Prosthetic Dentistry

Management of atypical occlusal discrepancy after condylar resection: A clinical report

  • Pierre-Luc Michaud
    Correspondence
    Corresponding author: Dr Pierre-Luc Michaud, Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, 5981 University Ave, Room 5161, P.O. BOX 15000, Halifax, Nova Scotia, B3H 4R2, CANADA
    Affiliations
    Fellow, Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

    Associate Professor, Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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  • Ruth A. Aponte-Wesson
    Affiliations
    Professor, Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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      Abstract

      This clinical report describes the prosthetic management of occlusion for a patient who had received condylar resection as part of cancer treatment. Previous reports have identified that patients with unrepaired segmental resection of the mandible experienced a frontal plane rotation of the mandible toward the nonsurgical side. In contrast, because of preservation of temporomandibular muscles and their attachments, the mandible rotated toward the surgical side, and occlusal contacts were limited to a pair of molars on that side. Manual manipulation and instructions for muscular stretching and massages were provided to reduce muscular tension. A mandibular guidance prosthesis was fabricated and gradually adjusted to guide the mandible progressively toward a normal position. These treatments helped improve general comfort, mastication, occlusion, and the gradual rotation of the mandible toward a normal position.
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