Functional Rehabilitation of Mandibular Defect Using CAD/CAM System.

Abstract

This report describes a case in which a removable partial mandibular denture made of polycarbonate resin was fabricated using a computer-aided design and manufacturing (CAD/CAM) system for a patient with microstomia and trismus caused by scar contracture in the maxillofacial region after multiple tumor resections and reconstructive surgeries. The patient was an 82-year-old woman with a history of multiple oral cancer surgeries and radiotherapy. She presented with a markedly narrow oral aperture circumference (145 mm) and had no prior experience with dentures. Given the difficulty of applying conventional impression techniques in this case, impressions were obtained using unilateral stock trays and split custom trays. The denture base and artificial teeth were milled from a polycarbonate disk into a single-piece structure to create a denture with no microgaps. One month after insertion, the patient's Oral Health Impact Profile-54 score improved from 36 to 6, masticatory efficiency increased from 84 mg/dL to 131 mg/dL, and the facial scale score improved from 13/20 to 7/20. Furthermore, the smooth denture surface minimized denture plaque adhesion, aiding oral hygiene maintenance. In addition to the low water absorption and high smoothness of polycarbonate resin, integrated design achieved using CAD/CAM contributes to the prevention of denture stomatitis and oral candidiasis.