PROSTHODONTICS - American College of Prosthodontists

December 2005, Supplement, Volume 14, Number 4 63c. Unstable/unretained prosthesisd. Tissue changes requiring modification/refabrication of prosthesise. Degradation of supporting dental or loss of anatomical structuresf. Fluid egress around obturatorg. Unrealistic expectationsh. Lack of patient compliance or understandingi. Ulcerationsj. Alterations in taste perceptionk. Endodontic/periodontal complicationsl. Material failure/incompatibilitym. Continued negative self-imagen. Nasal regurgitationo. Compromise of facial supportp. Loss of integration of implants secondary to adjunctive radiation therapy11B) Mandibular Defect1. Acquired2. Congenital and DevelopmentalResection or loss of a portion of the mandible can result in a variety of functional deficits thatare dependent on the extent of the defect (surgery, radiation, trauma), the concomitant therapy, andthe timing of rehabilitative efforts. The educationally qualified prosthodontist is best trained to evaluatethe defect and to coordinate and manage the design and fabrication of prostheses to compensate for theresulting functional loss. Prostheses may be fabricated for either a maxillary, mandibular, or combinationdefect. Secondary surgical reconstruction procedures to include osseointegration reconstruction aftertumor removal can improve post-surgical anatomy and thus enhance prosthesis stability and success.The prostheses can guide mandibular movement and assist in restoring the functions of mastication,deglutition, and speech, as well as restoring more normal facial form.Areas of consideration and reference include but are not limited to:Mandibular Reconstruction Prosthesis [21081CPT-2005]Mandibular Resection Prosthesis (w/guide) [D5934 CDT-2005, 21081 CPT-2005]Mandibular Resection Prosthesis (w/o guide) [D5935 CDT-2005, 21081 CPT-2005]Maxillofacial Stabilizing Prosthesis [21089 CPT-2005]Palatal Augmentation Prosthesis [D5954 CDT-2005, 21082 CPT-2005]Surgical SplintParameter Guidelines: Mandibular DefectICD-9 Codes – Acquired140.0–149.9160.0–160.9170.1195.0210.0210.9237.70–237.72237.9446.3446.4526.0–526.9787.2787.42010 CDEL Re-recognition of the Specialty Report 103 of 279