Oral carcinoma destroys structures, including the maxilla and mandible, which often require surgical management and rehabilitation. Poor tissue support after mandibular reconstruction in patients with hemimandibular defects hinders the reconstruction of functional and stable mandibular guide flange prostheses. The fabrication and use of a fixed guide flange prosthesis for rehabilitating patients with hemimandibular defects is described. The device permitted the use of the same prosthesis for both the functional and mechanical correction of mandibular deviation and is indicated where the fabrication of other appliances is contraindicated because of the compromised oral and physical state of the patient.