J Dent Rehabil Appl Sci.  2018 Sep;34(3):239-245. 10.14368/jdras.2018.34.3.239.

Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy

• Kim HS
• Park JY
• Yim SY
• Heo YR
• Son MK

• KMID: 2422643
• DOI: http://doi.org/10.14368/jdras.2018.34.3.239

Abstract

If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

Keyword

glossectomy; dysphagia; swallowing disorder; palatal augmentation prosthesis

MeSH Terms

Deglutition
Deglutition Disorders*
Denture, Complete*
Dentures
Glossectomy*
Humans
Jaw
Mouth Neoplasms
Prostheses and Implants
Tongue

Figure

• 

  Fig. 1 Initial intraoral photographs. (A) Occlusal view of maxillary arch, (B) Frontal view of maxillary & mandibular arch, (C) Occlusal view of mandibular arch, (D) A panoramic radiography.

• 

  Fig. 2 (A) Master cast, (B) Wax denture, (C) Wax denture try in.

• 

  Fig. 3 (A) Application of tissue conditioner before polished surface impression, (B) After polished surface impression.

• 

  Fig. 4 (A) Upper wax denture after trimming tissue conditioner, (B, C) Occlusal & rear view of cured upper complete denture with polished surface impression technique.

• 

  Fig. 5 Upper & lower denture delivery.

• 

  Fig. 6 A tongue pressure-measuring device (JMS tongue pressure measurement deviceTM).

• 

  Fig. 7 The tongue pressure test.

• 

  Fig. 8 Upper wax denture after polished surface impression. (A) Normal patient without dysphagia, (B) Patient with partial glossectomy.

Reference

References

1. Choi SW. Clinical diagnosis of oral cancer. J Korean Dent Assoc. 2011; 49:136–45.

2. Joo YH, Sun DI, Shin JH, Shin JH, Lee CH, Cho SH, Kim MS. The results of treatment in clinical NO oral tongue cancer. Korean J Otorhinolaryngol Head Neck Surg. 2007; 50:929–34.

3. Yoon JY, Lee SH, Lee JY, Oh NS. Prosthetic rehabilitation for a glossectomy patient - a clinical report. J Korean Acad Prosthodont. 2013; 51:347–52. DOI: 10.4047/jkap.2013.51.4.347.

4. Balasubramaniam MK, Chidambaranathan AS, Shanmugam G, Tah R. Rehabilitation of glossectomy cases with tongue prosthesis:a literature review. J Clin Diagn Res. 2016; 10:ZE01–ZE04. DOI: 10.7860/JCDR/2016/15868.7184. PMID: 27042596. PMCID: PMC4800663.

5. Marunick M, Tselios N. The efficacy of palatal augmentation prostheses for speech and swallowing in patients undergoing glossectomy:a review of the literature. J Prosthet Dent. 2004; 91:67–74. DOI: 10.1016/j.prosdent.2003.10.012. PMID: 14739896.

6. Kwag JM, Park II, Son MK. Suggestion for understanding and activation of the nursing home dentist system. Oral Biol Res. 2017; 41:127–33. DOI: 10.21851/obr.41.03.201709.127.

7. Sakai K, Nakayama E, Tohara H, Kodama K, Takehisa T, Takehisa Y, Ueda K. Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients:a crosssectional study. Clin Interv Aging. 2017; 12:1207–14. DOI: 10.2147/CIA.S141148. PMID: 28814847. PMCID: PMC5546916.

8. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly:management and nutritional considerations. Clin Interv Aging. 2012; 7:287–98. DOI: 10.2147/CIA.S23404. PMID: 22956864. PMCID: PMC3426263.

9. The glossary of prosthodontic terms. J Prosthet Dent. 2017; 117:e1–e105. DOI: 10.1016/j.prosdent.2016.12.001. PMID: 28418832.

10. Toyoshita Y, Koshino H, Hirai T, Matsumi T. Effect of wearing a palatal plate on swallowing function. J Prosthodontic Res. 2009; 53:172–5. DOI: 10.1016/j.jpor.2009.06.004. PMID: 19695975.

11. Ohno T, Fujishima I. Palatal and lingual augmentation prosthesis for patients with dysphagia and functional problems:a clinical report. J Prosthet Dent. 2017; 117:811–13. DOI: 10.1016/j.prosdent.2016.08.025. PMID: 27847156.

12. Ohno T, Ohno R, Fujishima I. Effect of palatal augmentation prosthesis on pharyngeal manometric pressure in a patient with functional dysphagia:a case report. J Prosthodont Res. 2017; 61:460–3. DOI: 10.1016/j.jpor.2017.01.006. PMID: 28233692.

13. Abdulhadi LM. Different techniques for palatal augmentation in partially glossectomized patients. A report of two cases. Open Access Scientific Reports. 2012; 1:391. DOI: 10.4172/scientificreports.391.

14. Robbins KT, Bowman JB, Jacob RF. Postglossectomy deglutitory and articulatory rehabilitation with palatal augmentation prostheses. Arch Otolaryngol Head Neck Surg. 1987; 113:1214–8. DOI: 10.1001/archotol.1987.01860110080012. PMID: 3663349.

15. Ono T, Hori K, Nokubi T. Pattern of tongue pressure on hard palate during swallowing. Dysphagia. 2004; 19:259–64. DOI: 10.1007/s00455-004-0010-9. PMID: 15667061.