Detachable Palatal Ramp of Teeth to Improve Comfort in a Completely Edentulous Patient with a Segmentally Resected Mandible

The rehabilitation of a completely edentulous patient with segmental resection of the mandible (without osseous reconstruction) poses a considerable challenge to the restoring prosthodontist. Due to the absence of natural teeth in both arches, it is difficult to correct the mandibular deviation with the aid of guidance prostheses. Prosthetic management of such patients usually consists of a maxillary complete denture and mandibular segmental denture occluding in the deviated position itself. An additional ramp or row of denture teeth is placed on the palatal surface of the maxillary denture to facilitate this; however, patient comfort levels (during functions such as phonation) are found to be adversely impacted due to the encroachment of the tongue space by the position of the ramp. This report describes an innovative technique to overcome this problem by fabrication of a detachable ramp of additional denture teeth in the maxillary denture. The patient could wear the denture comfortably without the palatal ramp throughout the day and could attach the palatal ramp while eating.