An interdisciplinary approach for the management and rehabilitation of a fibro-osseous neoplasm using platelet-rich gel and an implant-supported hybrid prosthesis.

Fibro-osseous neoplasms such as central ossifying fibroma (COF) can lead to destructive expansile lesions involving the maxilla or the mandible. Management of such lesions usually involves surgical intervention in the form of enucleation or resection. Platelet-rich gel (PRG) has been known to expedite bone regeneration due to its osteoconductive property. PRG initiates a greater and faster initial cellular response in comparison to platelet-rich plasma and has better handling characteristics. The challenge in rehabilitation often occurs due to the size of the osseous defects postsurgery. Fixed prosthodontic rehabilitation with endosteal implants is a viable treatment approach in such cases, improving the oral health quality of life and masticatory efficiency, when compared to a removable partial denture. This case report describes the management of an extensive lesion of COF using PRG and rehabilitation with a screw-retained, implant-supported hybrid prosthesis.

Prosthodontic rehabilitation of a sub-total maxillectomy defect with a definitive hollow obturator prosthesis using the modified lost-wax concept: A novel technique.

Squamous cell carcinoma (SCC) of the oral cavity is relatively common in the Indian subcontinent with surgical resection and adjuvant radiotherapy/chemotherapy being the treatment modality of choice. Prosthetic rehabilitation with an obturator following resection is more economical and yields satisfactory results. Better patient acceptance and comfort necessitates hollowing the prosthesis to a great extent. This novel method modifies the existing lost-wax technique in fabricating a definitive hollow maxillary obturator. An elderly man had reported to the Department of Prosthodontics with the chief complaint of a "big hole" in the mouth which affected his quality of life. He had undergone subtotal maxillectomy, following a histopathologic diagnosis of SCC, with adjuvant radiotherapy. Examination revealed an Aramany Class II defect with the healthy oral mucosa. A lightweight definitive obturator was designed and fabricated using a simple technique which utilizes easily available modeling wax. This article describes a relatively simple, single-step fabrication of a closed hollow-bulb obturator prosthesis with a uniform thickness of heat-cured resin encapsulating the hollow prosthesis.