Orthognathic correction and corticobasal implant-supported prostheses as a treatment modality for partial edentulism with mandibular prognathism: A case report and review of literature

Abstract

IntroductionMandibular prognathism manifests as elongation of the mandible in the anteroposterior direction, resulting in a sunken appearance of the middle third of the face and sad look of the eyes. It adversely affects esthetics, function, and oral health, reducing the patients' self-esteem. It therefore presents a significant challenge.Presentation of caseA 23-year-old woman presented with prognathic features characterized by mandibular protrusion, maxillary retrusion, a prominent chin, and reduce self-esteem. Intraoral examination revealed multiple extracted teeth, severe fracture of the crown at 23, mobility of the fixed prosthesis on 13, 14, 15, and 16, a root stump of 18, and periodontally compromised teeth (31, 32, 33, 41, and 42).A multidisciplinary team formulated the following treatment plan: stage 1, orthognathic osteotomy to retrude the mandible at 34 and 44; stage II, fabrication of transitional acrylic partial dentures; and stage III: fabrication of definitive corticobasal implant-supported prostheses. The patient was delighted with the treatment and complied with the oral hygiene instructions and follow-up program. After 7 years of function, the patient presented without complaints and exhibited significant improvement in oral health, self-esteem, and quality of life.DiscussionThe management of mandibular prognathism requires a multidisciplinary approach. The treatment implemented was considered the optimal option that aligned with the recommendations of several researchers to reduce facial disfigurement and rehabilitate the edentulous state.ConclusionThe use of corticobasal implant-supported prostheses for the rehabilitation of patients with partial edentulism can significantly improve the treatment outcome following orthognathic surgery in cases with mandibular prognathism.