RESUMO
Trismus is a post-radiotherapy complication that affects survivors of head and neck cancers. It is described as the reduction of mouth opening to less than 35 mm. The condition is a progressive process; hence early intervention is crucial to prevent further damage and weakness to the elevator muscles of the mandible. Here, we report a 40-year-old woman with known squamous cell carcinoma of the maxillary sinus in stage T3N0M0 who had undergone upper right partial maxillectomy with subsequent 33 fractions of radiotherapy (66 Gy; intensity-modulating radiotherapy). Five months post-radiotherapy, the patient showed interest in replacing her missing teeth to restore her oral functions and facial appearance. At her post-radiotherapy visit in the dental assessment clinic, she showed a mouth opening of 12 mm. The TheraBite® Jaw Motion Rehabilitation System™ and wooden tongue depressors were alternatively used for 6 weeks (4-5 stretches/day; each stretch held for 15 s). Mouth opening gradually increased to 20 mm. Consequently, a definitive obturator prosthesis was fabricated using computer-aided design and computer-aided manufacturing technologies with the 3Shape D900 model scanner. These were challenging and time-consuming steps, but acceptable facial appearance and mouth opening were restored for the patient. This case suggests that Therabite® Jaw Motion Rehabilitation SystemTM and wooden tongue depressors help to increase mouth opening significantly if used together and alternatively.
RESUMO
OBJECTIVE: To assess the satisfaction level and complaints among patients using different types of removable partial dentures (RPDs) in Makkah city, KSA. METHODS: In this retrospective study, 551 patients who had received RPDs between February and December 2015 were contacted by telephone. One hundred patients responded, and 60 of them agreed to participate in the study. The participants were asked two questions to determine their satisfaction level and complaints with RPD usage, eating, communication, and aesthetics. Data were analysed statistically by chi-square, analysis of variance, and Scheffe's tests. RESULTS: Of 60 patients, 35% were very satisfied, 21.7% were satisfied and 23.3% were nearly satisfied. However, only 20% were not satisfied. There were no significant differences in mean RPD satisfaction among different age groups and between sexes (P > 0.01). There was a significant difference in satisfaction among RPD type (P < 0.01). However, no significant differences were recorded between either metal and acrylic, or acrylic and flexible RPDs (P < 0.01). As many as 26.7% of respondents complained of aesthetic problems, 16.7% complained of pain during mastication, 10% complained of gag reflex, and 8.3% complained of phonetic problems. However, the majority of respondents (38.3%) had no complaints. CONCLUSION: The majority of patients were satisfied with the quality of removable partial dentures treatment in Makkah city hospitals. Oral rehabilitation with RPDs should be applied with care when patients have high aesthetic demands.
