Management of Edentulous Patients with Maxillary Substance Loss: A Case Report

Abstract

Depending on the location and extent of the loss of substance following maxillary resection surgery, all functions of the masticatory apparatus may be adversely affected. Eating and communication are impaired, which has a negative impact on the patient's psychological state [1]. When reconstructive maxillofacial surgery is not possible, rehabilitation with a maxillofacial prosthesis is essential. It must restore functions (phonation, eating, breathing, etc.) and reintegrate the patient into his psychosocial environment by masking his disability [2]. To achieve these objectives, this prosthesis, like a conventional removable prosthesis, must meet the Housset triad (support - retention - stabilisation), but also the objective of tightness. We therefore speak of a "prosthetic tetrad in PMF" (Housset's triad completed by the objective of tightness) [3]. In the case of a completely edentulous arch with substance loss, the treatment becomes more complex due to the reduced support surface. The maxillofacial prosthodontist must therefore be extremely vigilant to ensure the success of this appliance. A wise choice of technique and impression material, as well as respect for the occlusal parameters (occlusal plane, vertical dimension, centric relation, etc.) will ensure prosthetic stability and integration [4]. In this article, we will focus on the peculiarities of the management and the different stages in the fabrication of a maxillofacial prosthesis for a patient with total edentulism and loss of maxillary substance.