Dental rehabilitation of a patient with a temporomandibular joint contraction: a clinical case

Background. Complex rehabilitation of patients with malignant neoplasms of the oropharyngeal zone (OPZ) presumes great difficulties due to disruption of vital functions such as breathing, swallowing, chewing, speech, and also because of the lack of a single methodological approach to treatment. Despite the emergence of new methods and the improvement of existing ones, treatment of patients with OPZ malignancies remains a difficult task due to late detection of diseases, complicated clinical and anatomical variability in the structures of the maxillofacial region (MFR), as well as a significant number of concomitant complications. In addition to breathing, swallowing, speech disorders, the treatment of OPZ is often accompanied by postoperative microstomy (constriction of the oral slit), as well as the restriction of the mandible movement due to both temporary and persistent contracture of the temporomandibular joint and chewing musculature trismus. In this regard, there is a need to optimize the existing stages of prosthetics making and to increase the effectiveness of orthopedic rehabilitation of patients with OPZ tumors.

Material and methods. The description of clinical and laboratory stages of dental orthopedic rehabilitation for a patient with limited mouth opening associated with surgical treatment of OPZ is presented in the article. In terms of dental treatment, a patient with a post-exposure defect was offered to produce a maxillary resection prosthesis with an obturating part and optimization of some process steps and the use of auxiliary devices.

Conclusion. Thus, the modernization of dental rehabilitation of the patient with post-resectional maxillary defect ensured the implementation of orthopedic treatment in full, which contributed to the replacement of the lost functions of the maxillofacial area such as speech, breathing, eating and aesthetics, and had a positive impact on the patient’s quality of life.

Key words: maxillofacial prosthesis; dental rehabilitation; malignant neoplasms; contracture of the temporomandibular joint; microstomy; impression spoons

Authors declare no conflict of interests for this article.

Source of financing. Unspecified.

For citations: Kochurova E.V., Izhnina E.V., Nikolenko V.N., Lapina N.V., Seferyan K.G., Lazarev D.A. Dental rehabilitation of a patient with a temporomandibular joint contraction: a clinical case. Golova I Sheya Head and neck Russian Journal. 2018;6(1):57–63 (in Russian).

 The authors are responsible for the originality of the presented data and the possibility of publishing illustrative material – tables, drawings, photographs of patients.