Functional Magnetic Resonance Imaging of Chewing in Patients with Reconstructed Mandibles Rehabilitated by Implant Assisted Mandibular Removable Partial Overdenture

Abstract

Ten patients were selected from the out-patient clinic of the Plastic surgery Department, Faculty of Medicine, Ain-Shams University to asses the chewing function in patients with reconstructed mandibles after prosthodontic rehabilitation. Although the patients were fulfilling the inclusion criteria, yet three patients had to leave the study. One of the patients was having the tongue sutured to the buccal mucosa; a condition that would interfere with the chewing function. Another one was having a fracture in the bone graft revealed by conventional Computed Tomography scan with a history of recurrent plate fracture. The third one had to remove the plate for implant placement, yet its removal would result in mandibular fracture. Seven patients continued for implant placement. Cone Beam Computed Tomography helped to reveal the sites for implant positioning. Implants were placed parallel to each other. Three months later, prosthetic rehabilitation took place. Multi-unit abutments, open top impression technique, splinted impression posts and polyether impression material were used for the fabrication of the screw retained bar. CAD/CAM technology was used to mill the bar out of zirconia. The bar was then cemented to the Titanium bases of the multi-unit abutment using adhesive resin. The bar was then screwed in its position. The implant assisted removable partial overdenture was then fabricated in the conventional manner following the steps of impression making and bite registration. Clip attachment was used to retain the implant assisted removable partial overdenture to the bar.Six patients continued to the end of the prosthetic rehabilitation.