Hotta Hiromi, Kanai Yuki, Yamashita Shuichiro
Department of Clinical Oral Health Science, Tokyo Dental College, Tokyo, Japan.
Bull Tokyo Dent Coll. 2012;53(4):173-80. doi: 10.2209/tdcpublication.53.173.
When multiple tooth loss causes loss of occlusal-masticatory function, functional recovery is normally obtained with the help of removable dentures. After resection of the jawbone or tongue because of tumors, the movement of the tongue and its surrounding tissues is limited, and patients exhibit a more pronounced loss of chewing and swallowing than that observed in other cases of multiple tooth loss. In such cases, it is necessary to take extra care in determining the position of the mandible, arrangement of artificial teeth, and morphology of the palate. In the present case, the left lower jawbone was resected because of a gingival tumor, and when the new denture was manufactured, the intercuspal position was based on the resting position of the mandible. The stability of the lower complete denture was a priority and the artificial teeth were partially arranged on the lingual side. The new denture, however, caused insufficient closing of the mouth aperture and insufficient impact between tongue and palate, resulting in dysphagia. Therefore, the vertical dimension of occlusion was reduced multiple times to improve chewing and swallowing function.
当多颗牙齿缺失导致咬合咀嚼功能丧失时，通常借助可摘义齿来恢复功能。因肿瘤切除颌骨或舌头后，舌头及其周围组织的活动受限，患者咀嚼和吞咽功能丧失比其他多颗牙齿缺失的情况更为明显。在这种情况下，确定下颌位置、人工牙排列和腭部形态时需要格外小心。在本病例中，因牙龈肿瘤切除了左下颌骨，制作新义齿时，牙尖交错位基于下颌的休息位。下全口义齿的稳定性是首要考虑因素，人工牙部分排列在舌侧。然而，新义齿导致张口度不足以及舌头与腭部之间的冲击不足，从而引起吞咽困难。因此，多次减小咬合垂直距离以改善咀嚼和吞咽功能。
