Occlusally oriented impressions for large maxillary stomas.

A stable record base is critical to the making of an accurate centric jaw relation record. This is attained by meeting three criteria: (1) a well adapted, adequately extended record base, (2) adequate support of the alveolar bone to prevent excessive movement of the record bases, and (3) accurate tissue integrity to allow good base adaption, maximum tissue contact, and minimum movement. If these criteria cannot be met--and they cannot in the bilateral subtotal maxillectomy patient--then an alternative method must be used. The combination jaw relation record-impression technique using the patient's pre-existing occlusion is an alternate method for the fabrication of a stable prosthesis. This method has been tested in several maxillofacial prosthodontic centers and has proved to constitute a realistic approach to the management of the subtotal maxillectomy patient.