A case report on prosthodontic reconstruction for open-bite resulting from mandibular condylar tumor resection

Purpose: A 57-year-old female was referred to our hospital complaining of esthetic disorder due to osteochondroma of her right condylar head. After mandibular condylar tumor resection, an intraoral inspection revealed wide-area bilateral open-bite. The appropriate position of the mandible including horizontal balance was investigated using a provisional restoration. After confirming the horizontal balance of the mandible and the absence of new temporomandibular joint symptoms with normal mandibular movement, prosthetic treatment was performed to reconstruct mastication and esthetic functions.Discussion: Osteochondroma is a slow-growing benign tumor, so it took a long time for the patient to recognize facial asymmetry by herself. Functional recovery was achieved through a prosthetic procedure that applied different occlusal vertical dimensions to the left and right sides of the mandible. However, the mandible returned to its original position that had held a horizontal balance after the condyle resection surgery. As a result, it was considered that the right side contacted prematurely and wide-area bilateral open-bite appeared. Searching for an appropriate mandibular position, the occlusal vertical dimension and reconstructing anterior guidance were deemed to greatly affect the prognosis in this and similar cases.Conclusion: The prosthetic procedure using a provisional restoration while maintaining the mandibular horizontal balance was successfully applied to bilateral open-bite which widely appeared after mandibular condyle resection. It is likely that post-surgical tissue stabilization will need several months to a year in benign tumors that have been growing for a long time. It is suggested that appropriate prosthetic intervention according to the three-dimensional changes in the jaw position is required in such cases.