title: Implant-supported prostheses with temporomandibular joint reproduction after hemimandibular resection: a case report.
abstract: OBJECTIVE
  The change in anatomy and physiology resulting from radical mandible surgery is often exacerbated by radiation therapies that make the mucosa atrophic and susceptible to irritation and ulceration rendering the task of areating functional complete dentures for edentulous subjects very challenging to prosthodontists. The aim of this study is to describe an implant supported denture rehabilitation in an edentulous hemimandibulectomized patient with a singular prosthetic design in order to compensate for the lack of a condylar process.
  
  
  METHODS
  The subject of the clinical case, had a history of squamous cell carcinoma of the right tonsillar region for which it was subjected to a hemimandibulectomy and was primarily rehabilitated with an over denture mounted onto a bar furnished by a resin condylar eminence in articulation with the glenoid fossa of the upper denture. The need to provide greater stabilization for the upper prosthesis led to a maxillary implant insertion and to the realization of a new joint connection that was constituted inferiorly by a titanium condyle and superiorly by a teflon acetabulum.
  
  
  CONCLUSIONS
  The prosthetic balance guaranteed by the second rehabilitation greatly affected the biomechanics of mastication leading to a reduction of eccentric interferences, a stabilization of centric occlusion, and a lowering of intensity contraction by masticatory muscles. This difference is well represented by two and three-dimensional plans obtained from the application of a T-Scan III device.
  
  
  CONCLUSIONS
  The rehabilitative solution proposed was effective in resolving the lateral deviation, in relieving masticatory and speech discomfort, as well as restoring an aesthetically acceptable appearance in a hemimandibulectomized and not reconstructed patient.
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Fabrizio
authors: F
authors: Carini
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Salvatore
authors: S
authors: Longoni
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Valeria
authors: V
authors: Pisapia
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Gianbattista
authors: G
authors: Gatti
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Dario
authors: D
authors: Monai
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Gianluca
authors: G
authors: Porcaro
keywords: computerized occlusion analysis; condylar prosthesis; hemimandibulectomy; implant-supported prostheses; mandibular deviation