Abstract
Statement of problem
Patients with a mandibular defect can develop mandibular deviation, resulting in a
loss of or reduction in occlusal contact and ultimately loss of function. The occlusal
ramp is a prosthesis used to help restore the masticatory function of such patients
and is used particularly in the maxillofacial rehabilitation of patients with masticatory
dysfunction resulting from mandibular deviation. The occlusal ramp is usually attached
to a mandibular denture or worn as an independent device placed on the palate corresponding
to the mandible that produces the offset. However, evidence of the effects of its
use is sparse.
Purpose
The purpose of this clinical study was to investigate the effects of occlusal ramp
use in functional rehabilitation.
Materials and methods
This study included 10 patients who had received mandibulectomies (5 men and 5 women;
mean age 76.7 years, range 67 to 90 years) with deviation of the mandible. An occlusal
ramp was fabricated for each participant as part of their maxillofacial prosthetic
treatment. Masticatory performance was evaluated before and after the treatment by
measuring glucose extraction while masticating a piece of gummy jelly. The Wilcoxon
signed-rank test was used for statistical analysis (α=.05).
Results
The median masticatory performance score, represented as glucose concentration (mg/dL),
was 82.45 before treatment and 115.45 after treatment, with an overall improvement
of 33.00. Scores differed significantly before and after treatment (P=.005). Masticatory performance for each participant improved in the range of 17.7
to 103.3, highlighting the role that the occlusal ramp played in mastication, although
with differing effects in each participant.
Conclusions
Masticatory performance in participants with mandibular deviation after a mandibulectomy
was significantly improved with an occlusal ramp. This suggests the effectiveness
of using occlusal ramps in maxillofacial prosthetic treatment for the recovery of
masticatory function in patients with mandibular deviation.
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Article info
Publication history
Published online: May 21, 2021
Footnotes
Presented at the 36th Annual Meeting of Japanese Academy of Maxillofacial Prosthetics, held in Sendai, Japan from June 27 to 29, 2019.
Support provided by project for Promoting Leading edge Research in Oral Science at Tokyo Medical and Dental University; Partially supported by JSPS KAKENHI (grant number JP17H00755) and by the Japanese Dental Science Federation (JDSF-DSP1-2017-210-1).
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
