Treatment Considerations for Mandibulectomy Patients with Temporomandibular Dysfunction

U radu se opisuje rehabilitacija deformiteta mastikatornog sustava i temporomandibularne disfunkcije (TMD-a) nakon operativnog uklanjanja malignog tumora donje čeljusti i radijacijske terapije regije glave i vrata. Uspješna protetska rehabilitacija i prihvatljivi konačni odnos gornje i donje čeljusti postignuti su zahvaljujući miofunkcionalnoj fi zikalnoj terapiji, udlagama za repoziciju, privremenim štitnicima te okluzalnim usklađivanjem ili modifi kacijama oblika nadomjestaka. Opisana je protetska opskrba pacijenata s poslijeoperativnim defektima donje čeljusti (nakon hemimandibulektomije) te uloga potporne fi zikalne terapije i mioterapije kako bi se ponovno postigla funkcionalna učinkovitost mastikatornog sistema.This study discusses rehabilitation of masticatory system deformities and temporomandibular dysfunctions (TMD’s) following surgery for malignant tumors of the mandible and radiation therapy of the head and neck region. Successful prosthodontic rehabilitation results and acceptable fi nal maxillomandibular relationships were achieved with the help of myofunctional training therapy, repositioning splints, temporary mouth-guard appliances, and occlusal adjustments or modifi cations of denture design. Prosthodontic treatment of patients with postoperative mandibular defects (following hemi-mandibulectomy) is described, and the role of supporting physiotherapy and myotherapy in regaining functional effi ciency of the masticatory system was emphasised