Balance and symmetry of mandibular function is disturbed by loss of continuity of the mandible, which leads to altered mandibular movements and deviation of the residual fragment, as a consequence of which problems with chewing, swallowing, speech, and aesthetics develop. Methods such as maxillary fixation, and use of mandibular and palatal guidance have been used to reduce or eliminate the mandibular deviation. The aim of this study was to achieve a normal maxillomandibular relation in a patient with mandibular discontinuity. An acceptable maxillomandibular relation was obtained within 3 months with a maxillary guidance ramp prosthesis. (C) 2006 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.