Precision with semi-precision attachment using CAD/CAM technology for a mandibulectomy patient: A case report

Rehabilitation of mandibular defects post-marginal mandibulectomy presents significant challenges due to altered anatomy, reduced denture-bearing areas, and compromised muscle attachments that affect tongue mobility, speech, and mastication. Traditional implant-supported options may be unsuitable for patients with insufficient bone support, necessitating alternative prosthetic approaches to restore function and aesthetics.A 17-year-old male underwent a marginal mandibulectomy for odontogenic keratocyst, resulting in a Cantor and Curtis Type V defect. Examination revealed limited residual dentition and insufficient bone volume for implants. The patient reported difficulties with mastication and speech, requiring a stable, retentive prosthesis that would not exacerbate the altered mandibular anatomy.A removable cast partial denture with semi-precision attachments was fabricated using CAD/CAM technology for accuracy and ease of customization. This approach provided necessary retention, stability, and comfort while accommodating the anatomical limitations. The patient reported significant improvements in mastication, speech, and aesthetics, along with high satisfaction. Semi-precision attachments offer enhanced stability in cases where conventional direct retainers may be insufficient, distributing occlusal loads effectively across limited supporting structures. CAD/CAM technology facilitated precise attachment placement and minimized chairside adjustments, further improving patient comfort and prosthesis function.For patients with mandibular defects unsuitable for implants, a removable prosthesis with semi-precision attachments, designed with CAD/CAM technology, provides a reliable, conservative alternative. This approach achieves satisfactory functional and aesthetic outcomes, demonstrating the value of modern digital design and attachment-retained prostheses in complex rehabilitative cases.