Case report No. 3

Mrs. S., 68, comes to see an improvement in the aesthetics of the mandibular denture very old and revised. It also asks whether it is possible to increase the stability of the prosthesis. It is a tidy and elegant woman.

The examination revealed a congenital asymétriefaciale treated by surgery at the age of 50. Many setbacks, following this intervention, resulted in a significant loss of tissue on the left. The disfigurement is important (Fig. 17). A bone graft was performed auniveau left of the horizontal branch of the mandible with a conjunctival graft at the floor of the mouth in the area.

Fig. 17 - Lack of substance very important.

Physical examination shows a support surface highly discordant (Fig. 18), with muscular hypotonia gauche.Au maxilla, is present in a natural dentition. The panoramic radiograph shows the extent of the difficulties in managing (fig. 19). In addition, this patient has a severe Angle Class II (Fig. 20).

Given all this, the treatment plan proposes the creation of a mandibular complete denture lined with a flexible base (fig. 21). The achievement was made prosthetic conventional manner. However, once the prosthesis is completed, it was made a recording of the upper prothèseau using a plastic resin Aprisa delayed by the Hydrocast. A second firing has perfect all the support muscles (Fig. 22 and 23). Without solving the problem of loss of substance to deface, aesthetics is satisfactory and its setting has been followed step by step by the patient.

The treatment of these clinical cases shows that flexible bases have an important role to play in addressing certain clinical situations and should be considered as a treatment in its own right and not as something marginal, it is true that anatomical and functional issues present, are often added anxiety or psychological distress. To establish the relationship between the patient and the practitioner is, in these cases, a value of paramount importance.

If the databases can provide a flexible solution (sometimes the only) Aces clinical situations, it is important to know that there a number of constraints on the nature of these materials and that can not be overcome. The practitioner, but the patient must be informed and aware to make the most.

Fig. 18 - Surface support mandibular very weak.

Fig. 19 - No condyle.Greffe bone left of the horizontal branch.

Fig. 20 - Class II severe.

Fig. 21 - The use of prosthesis in the mouth (Vertex).