Specific considerations are needed for the dental treatment of patients with rheumatoid arthritis because they may experience disease-related problems such as trismus, impairment of the temporomandibular joint or hands, and side effects of medication that affect alveolar bone. Here we describe successful prosthetic treatment that addressed disease-related problems, including trismus, in a patient with rheumatoid arthritis. (Int J Maxillofac Prosthetics 2022;5:18-21)

Background: Older adults who have undergone surgery for oral tumors are at increased risk of impaired masticatory rhythm. This study investigated the correlations between masticatory rhythm, objective masticatory performance, and subjective masticatory performance as well as factors related to masticatory rhythm. Methods: The participants were 44 adults (24 men, 20 women; age range 42~90 years old) who had undergone maxillectomy, mandibulectomy, or glossectomy and were rehabilitated with a maxillofacial prosthesis. The number of functional contact teeth pairs was confirmed by intraoral examination. Chewing rate, cycle duration, coefficient of variation (CV) for cycle duration (reflecting the stability of masticatory rhythm), and mixing ability were measured simultaneously using a mastication movement rhythm tracking device during gum chewing. Maximum occlusal force was measured using the dental prescale system. Patients’ perception of chewing ability was rated using a questionnaire. Results: The Spearman’s rank correlation test revealed that mixing ability, patient-rated masticatory scores, cycle duration, CV for cycle duration, and maximum occlusal force showed significant correlations with chewing rate. Multiple linear regression analysis identified mixing ability and the CV for cycle duration as significant predictors of masticatory rhythm. Conclusions: Factors associated with a faster chewing rate were higher mixing ability and masticatory scores, greater maximum occlusal force, shorter cycle duration, and smaller CV for cycle duration. Stable masticatory rhythm and mixing ability are significant predictors of chewing rate. Poor masticatory performance and unstable masticatory rhythm can result in slower chewing and thus a higher risk of inadequate dietary intake.

A lingual augmentation prosthesis (LAP) is an appliance attached to the mandible to increase swallowing by extending the denture base area. It has been proven that the swallowing function improves with the insertion of an LAP assisting the palatal augmentation prosthesis (PAP). We delivered both the PAP and LAP to a patient with subtotal glossectomy who experienced saliva drooling and masticatory dysfunction. As the dead space between the reconstructed tongue and dentures decreased in both the vertical and anterior directions, his maximum tongue pressure increased, and the status of salivation and food residue improved. LAP assisted not only for saliva drooling control but also mastication.