Surgical experiences of complete denture patients.
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A technique has been described for split-thickness skin grafting after resection of superficial carcinoma for both the mandibular and maxillary arch. The technique is a cooperative effort between the surgeon and the prosthodontist.
The use of a simple patient-held prosthesis for improving speech in a patient with mandible and tongue resections has been described. As subjectively perceived and objectively verified, speech intelligibility improved in a test patient. There were no apparent risks or lengthy therapy. The ease of fabrication and low cost indicate that this prosthesis may be of value in aiding the speech of glossectomy patients.
Surgical resection of a segment or loss of mandibular continuity can adversely affect most of the structures essential for maximum occlusal force. Five subjects who had partial mandibular resections for treatment of squamous cell carcinoma were studied. Occlusal force was recorded before and after cancer treatment and following prosthetic rehabilitation. A gnathodynamometer was used to record anterior occlusal force. Five edentulous and five dentate cancer-free subjects matched for age were studied to establish comparable normative data. The null hypothesis that partial mandibular resection would not affect maximum occlusal force was rejected (p = 0.0101). Mandibular resection did alter maximum occlusal force. The impact of the decrease in maximum occlusal force on masticatory function is yet to be determined.
A study of the dental status of 947 patients with oral cancer was conducted to determine how dentists might gain better access to patients in whom this disease develops. This access could lead to earlier diagnosis and thereby improve the prognosis. Dental profiles revealed that 68% of the patients were partially or totally edentulous, 14% had neglected teeth, and the remaining 18% had intact dentitions. The mean age of patients was 61.7 years. Efforts should be made to promote the recall of edentulous patients. This may facilitate an earlier discovery of many oral cancers.
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