Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients

<i>Background and Objectives:</i> Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who hav...

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Main Authors: Edoardo Brauner, Federico Laudoni, Emilia Rampelli, Andrea Bellizzi, Francesca De Angelis, Nicola Pranno, Andrea Battisti, Valentino Valentini, Stefano Di Carlo
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/1931
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author Edoardo Brauner
Federico Laudoni
Emilia Rampelli
Andrea Bellizzi
Francesca De Angelis
Nicola Pranno
Andrea Battisti
Valentino Valentini
Stefano Di Carlo
author_facet Edoardo Brauner
Federico Laudoni
Emilia Rampelli
Andrea Bellizzi
Francesca De Angelis
Nicola Pranno
Andrea Battisti
Valentino Valentini
Stefano Di Carlo
author_sort Edoardo Brauner
collection DOAJ
description <i>Background and Objectives:</i> Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who have undergone hemimanidublectomy without the reestablishment of mandibular continuity. <i>Materials and Methods:</i> Data were collected retrospectively on 10 patients with varying degrees of mandible resection. The greatest challenge in the restoration of an acceptable occlusion form is the natural latero-deviation that occurs in patients whose mandibular continuity was not restored. This causes an unbalanced and uncoordinated occlusal plane. Based on our research, this deviation is highly dependent on three main factors: the presence of teeth (which allow for a proprioceptive stimulus that counteracts the deviation), the extension of the defect and the presence or lack of the coronoid process. <i>Results:</i> Based on the presence of dental elements or lack thereof, patients were either rehabilitated with implant-supported dentures or removable partial dentures. Although the gold standard of care for these patients remains the restoration of mandible continuity through use of bone grafts, an acceptable rehabilitation of occlusion and therefore function may be acquired in non-grafted patients. <i>Conclusions:</i> Both physicians and patients must manage their expectations carefully and be eager to find a compromise to provide the best possible solution given the challenges of the premises.
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spelling doaj-art-501e3e09b85d4131b0e7b137255d4bf92025-08-20T02:00:43ZengMDPI AGMedicina1010-660X1648-91442024-11-016012193110.3390/medicina60121931Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy PatientsEdoardo Brauner0Federico Laudoni1Emilia Rampelli2Andrea Bellizzi3Francesca De Angelis4Nicola Pranno5Andrea Battisti6Valentino Valentini7Stefano Di Carlo8Department of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, ItalyDepartment of oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy<i>Background and Objectives:</i> Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who have undergone hemimanidublectomy without the reestablishment of mandibular continuity. <i>Materials and Methods:</i> Data were collected retrospectively on 10 patients with varying degrees of mandible resection. The greatest challenge in the restoration of an acceptable occlusion form is the natural latero-deviation that occurs in patients whose mandibular continuity was not restored. This causes an unbalanced and uncoordinated occlusal plane. Based on our research, this deviation is highly dependent on three main factors: the presence of teeth (which allow for a proprioceptive stimulus that counteracts the deviation), the extension of the defect and the presence or lack of the coronoid process. <i>Results:</i> Based on the presence of dental elements or lack thereof, patients were either rehabilitated with implant-supported dentures or removable partial dentures. Although the gold standard of care for these patients remains the restoration of mandible continuity through use of bone grafts, an acceptable rehabilitation of occlusion and therefore function may be acquired in non-grafted patients. <i>Conclusions:</i> Both physicians and patients must manage their expectations carefully and be eager to find a compromise to provide the best possible solution given the challenges of the premises.https://www.mdpi.com/1648-9144/60/12/1931hemimandibulectomymaxillofacial surgerydental implantprosthetic rehabilitationocclusal plane
spellingShingle Edoardo Brauner
Federico Laudoni
Emilia Rampelli
Andrea Bellizzi
Francesca De Angelis
Nicola Pranno
Andrea Battisti
Valentino Valentini
Stefano Di Carlo
Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
Medicina
hemimandibulectomy
maxillofacial surgery
dental implant
prosthetic rehabilitation
occlusal plane
title Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
title_full Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
title_fullStr Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
title_full_unstemmed Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
title_short Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients
title_sort functional rehabilitation in non reconstructed hemimandibulectomy patients
topic hemimandibulectomy
maxillofacial surgery
dental implant
prosthetic rehabilitation
occlusal plane
url https://www.mdpi.com/1648-9144/60/12/1931
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