Sensor-Enabled Palatal Ramp Prosthesis for Neuromuscular Re-education Following Hemimandibulectomy: A Case Report

Hemimandibulectomy may result in mandibular deviation toward the resected side due to loss of mandibular continuity and unopposed muscular forces, leading to impaired mastication, speech difficulties, and difficulty achieving functional occlusion. Conventional prosthodontic rehabilitation using guide flange and palatal ramp prostheses can assist mandibular guidance but relies on patient compliance and repeated functional training. This case report describes the rehabilitation of a 58-year-old male patient who presented with severe mandibular deviation following right-sided hemimandibulectomy performed for squamous cell carcinoma. A maxillary palatal ramp prosthesis incorporating a touch sensor-based wireless auditory feedback system was fabricated to provide immediate auditory feedback during mandibular guidance exercises. The sensor-enabled prosthesis was used as a temporary training appliance for six months to facilitate mandibular guidance and neuromuscular re-education. At baseline, mandibular deviation was approximately 15 mm from the facial midline, and the maximum mouth opening was 25 mm. Following the six-month rehabilitation period, the patient demonstrated improved mandibular guidance and functional performance. At the final 18-month follow-up, mandibular deviation was 5 mm, and the maximum mouth opening was 32 mm. Improvement in intercuspation, mastication, and speech was also clinically observed. The sensor-enabled appliance remained functional throughout the six-month training period, and no device-related complications were observed. The sensor-assisted palatal ramp was associated with improvement in mandibular guidance and functional measures in this patient. The appliance served as a temporary rehabilitation and training device rather than a definitive prosthesis. As this was a single-patient, uncontrolled case report, the findings should be considered preliminary, and further clinical evaluation is required to determine the effectiveness and generalizability of this approach.