Rehabilitation protocol of an edentulous patient with atrophic ridge after osteoradionecrosis

Description: Female patient, 40 years-old, complete edentulous with atrophic residual ridges and bearer of complete upper denture. Previous history of carcinoma of the oral cavity subjected to partial right glossectomy. Subsequently suffered an episode of osteoradionecrose post-extraction in the 4th quadrant which resulted in a severe mandibular defect. In first phase has been developed the clinical history of the patient, orthopantomography, teleradiography and carried out preliminary impressions with an irreversible hydrocolloid. As treatment plan the option was a conventional prosthetic rehabilitation protocol with a total mucus-supported prothesis. From the models were made individual trays. Final prints were made with heavybody and extralight-body. After obtaining the models, was developed an upper jaw registration plate for aesthetic evaluation, a mandibular stabilized plate for determination of the neutral zone and two stabilized plates (maxillary/mandibular) to make an intermaxillary dynamic register. This was followed by the teeth trial and insertion. Discussion: atrophic ridges constitute a challenge to the oral rehabilitation especially when facing obstacles to the use of implants. In cases of bone radionecrosis in addition to the atrophy of the ridge, this presents considerable defects affecting the stability/retention of rehab. However, through a careful clinical protocol: accurate prints, determining the neutral zone and making a intermaxillary dynamic register based on gothic arch tracing you can restore health, function and aesthetics of these patients. Conclusions: despite anatomical constraints, was possible to improve the patient quality of life and wellness without the use of implants. Keywords: rehabilitation, prosthodontics, removable, edentulous, atrophic, osteoradionecrosis