Prosthodontic management of hemimandibulectomy patients to restore form and function - A case series

Table 1 Protocol for guiding flange

Based on time of referral
1	Before surgery - 1 wk post-surgery	Intermaxillary fixation done with elastics
2	1 wk post-surgery - 1 mo	GF prosthesis and Physiotherapy
3	1 mo - 1 yr	Active physiotherapy, Counseling followed by GF prosthesis
4	> 1 yr	Surgical intervention
Based on amount of tissue resected
1	Amount of hard and soft tissue	Directly influences success and difficulty in rehabilitation
2	Segmental resection of mandible distal to cuspid	Maxillary or Mandibular GF
2	Segmental resection of mandible that involves canine	Maxillary GF is the choice as the loss of mandibular canine results in more downward rotation of mandible and the mandibular GF might not be stable
Types of prosthesis
1	Acrylic GF	Immediately after surgery and as training prosthesis
2	Definitive Cast metal GF	One year after training prosthesis
Modifications
1	To prevent supraeruption	Occlusal table on Maxillary teeth on defect side
2	To stabilize occlusion	Functionally generated occlusal table on Maxillary teeth on nondefect side
	Intervention	Prognosis
1	From the time of planning and surgery	Better
2	Long time interval after surgery	Guarded

GF: Guiding flange.