The role of non-contact digitizer in geometrical evaluation of mandibular prostheses effect on facial asymmetry of mandibulectomy patients

Purpose: This study sought to geometrically evaluate the effect of a mandibular prosthesis on facial asymmetry in patients with one of two different types of mandibulectomy defect. Methods: Facial data from 20 participants (9 men and 11 women; mean age 68 years) with either a reconstructed segmental defect (segmental group,n = 10) or a marginal mandibulectomy defect (marginal group, n =10) were acquired with a non-contact three-dimensional (3D) digitizer. Facial asymmetry was evaluated by superimposing a facial scan onto its mirror scan using 3D evaluation software. Facial scans with and without the mandibular prosthesis in place were also superimposed to evaluate the effect of the mandibular prosthesis. Results: Facial asymmetry differed significantly between subjects with and without the prosthesis in the segmental group (P = 0.005) but not in the marginal group (P = 0.16). There was no significant difference in the effect of the prosthesis on facial appearance between the two groups (P = 0.052). The ratio of 3D deviation of facial asymmetry without the prosthesis and in the mirror scan with the prosthesis differed significantly between the two groups (P = 0.01). Conclusions: Placement of a mandibular prosthesis has a notable effect on facial asymmetry in patients with segmental mandibulectomy defects

A Nonconventional Approach to Prevent Mouth Dryness in A Patient with A Complex Maxillofacial Defect

This report describes prosthetic rehabilitation of a patient with dry mouth due to a complex maxillofacial defect. The patient had undergone 5 surgical operations because of repeated recurrence pleomorphic adenoma, which resulted in partial maxillectomy followed by total maxillectomy, and finally orbital resection. The patient was left with oral, nasal, and orbital communication. Rehabilitation with a silicone facial cover was planned because the patient’s chief complaint was mouth dryness during sleep, and air leakage through the defects was considered a cause of this dryness. Furthermore, the patient was reluctant to use a conventional prosthesis for the time being. A silicone facial cover was fabricated. The patient's speech and sleep quality were evaluated with and without the cover, and the patient’s oral dryness was found to improve with use of the cover. Use of a silicone facial cover instead of a conventional prosthesis gave a satisfactory result, and is one option for preventing mouth dryness in a patient with multiple facial defects. (Int J Maxillofac Prosthetics 2020;3:7-11

Piezography Approach to Denture Fabrication for A Partial Glossectomy Patient: A Clinical Report

To provide a mandibular complete denture for a patient with a partial glossectomy and partial mandibulectomy, the denture space was captured using a piezography technique involving silicone impression materials with two different viscosities. Artificial teeth were arranged within the obtained piezographic index, and the denture was processed in the conventional manner. Using the piezography technique described enables physiologically appropriate complete dentures to be fabricated based on the neutral zone concept. (Int J Maxillofac Prosthetics 2021;4:37-42