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January 24, 2026Journal of Prosthodontics0 citationsOpen Access

Navigating challenges in prosthodontic rehabilitation after long‐term delay following fibula free flap reconstruction with a unique overlay removable prosthesis and large vertical dimension increase

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DMDavid McReynoldsAMAdvan MoorthyLSLeo F A Stassen

Key Points

  • This report aims to detail the complexities and solutions in prosthodontic rehabilitation after a significant treatment delay.
  • Managed a case involving a 7-year delay in prosthodontic treatment.
  • Developed a personalized treatment plan including healing abutments and an implant indexing device.
  • Fabricated an overlay prosthesis with a 12 mm increase in vertical dimension.
  • Patient tolerated the increased vertical dimension well over 68 months of follow-up.
  • Recorded two minor technical complications related to denture tooth debonding.
  • Observed one case of localized peri-implant mucositis during the follow-up period.

Abstract

Abstract This case report highlights the experience of one maxillofacial surgical patient who delayed prosthodontic treatment for 7 years as they saved to self‐fund access to a subsidized prosthodontic service. Without the benefit of a restored opposing dentition for a prolonged period of time, maxillary occlusal plane disruption occurred as a downstream clinical consequence. To manage the complexities arising from delayed presentation, the prosthodontic team developed a highly tailored treatment plan to meet the patient's unique clinical needs, which included fabrication of customized healing abutments, an implant indexing device, and a definitive removable implant‐tooth‐supported occlusal overlay prosthesis, which incorporated an atypical increase in the vertical dimension of occlusion (VDO) of 12 mm. Following 68 months of follow‐up, the patient tolerated the increase in VDO well. Two minor technical complications occurred (denture tooth debond events) and one minor biological complication (localized peri‐implant mucositis) within the follow‐up period. This report underscores the role of timely prosthodontic involvement in interdisciplinary maxillofacial treatment pathways and advocates for the prioritization of equitable access to specialist prosthodontic services to mitigate preventable challenges in this vulnerable patient cohort.

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Cite This Study

McReynolds et al. (2026) studied this question.

synapsesocial.com/papers/6974610cbb9d90c67120af4bhttps://doi.org/10.1111/jopr.70094
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