Management of hemimandibulectomy using guide flange

Abstract

Patients with mandibular deviation following surgical hemi/segmental/subtotal mandibulectomy for a variety of reasons (squamous cell carcinoma being the most common cause) are administered a guide flange. The physician must wait for the lesion to heal, the graft to heal, or the radiotherapy effects to subside before proceeding with planned procedures like secondary osseous grafting. A definitive prosthesis cannot be planned until the graft has healed. The patient has to receive a prosthesis during this period of time in order to correct mandibular deviation caused by a unilateral muscle pull. Furthermore, if bone grafting fails or the patient refuses a second operation, there are situations in which a definitive prosthesis must be postponed. This report describes the fabrication of such a mandibular guide flange prosthesis.