Functional Rehabilitation in Non-Reconstructed Hemimandibulectomy Patients

Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who have undergone hemimanidublectomy without the reestablishment of mandibular continuity. Data were collected retrospectively on 10 patients with varying degrees of mandible resection. The greatest challenge in the restoration of an acceptable occlusion form is the natural latero-deviation that occurs in patients whose mandibular continuity was not restored. This causes an unbalanced and uncoordinated occlusal plane. Based on our research, this deviation is highly dependent on three main factors: the presence of teeth (which allow for a proprioceptive stimulus that counteracts the deviation), the extension of the defect and the presence or lack of the coronoid process. Based on the presence of dental elements or lack thereof, patients were either rehabilitated with implant-supported dentures or removable partial dentures. Although the gold standard of care for these patients remains the restoration of mandible continuity through use of bone grafts, an acceptable rehabilitation of occlusion and therefore function may be acquired in non-grafted patients. Both physicians and patients must manage their expectations carefully and be eager to find a compromise to provide the best possible solution given the challenges of the premises.