Correction of deviation of a partially resected mandible using a palatal ramp with the aid of a semi-adjustable articulator.

Abstract

Patients having undergone hemi-mandibulectomy without further reconstruction (to restore the lost mandibular continuity) suffer functional limitations due to the resultant deviation of the segmental mandible. A palatally based guidance prosthesis (or palatal ramp prosthesis) is often indicated and is usually fabricated chairside in self-cured acrylic resin. Establishing the correct angulation of the slope of the palatal ramp may take several attempts before a satisfactory correction is achieved. This clinical report describes a laboratory technique in which a semi-adjustable articulator was used for fabricating the palatal ramp prosthesis. The patient's deviated mandibular position was transferred to the articulator by means of a facebow and interocclusal record. The angulation of the palatal ramp was then established on the semi-adjustable articulator and the prosthesis fabricated in heat-cured acrylic resin. Reduced chairside time, improved patient comfort levels, and ease in fabrication of the prosthesis on the semi-adjustable articulator are proposed advantages of the described technique.