Satisfaction of patients with amyotrophic lateral sclerosis with an oral appliance for managing oral self-biting injuries and alterations in their masticatory system: A case-series study

An approach to a repeated self-biting tongue injury in a toddler

BACKGROUND

Children with tongue injuries often visit the pediatric emergency department. The vast majority of cases can be conservatively treated, while some injuries require operative repair. The aim of this article was to demonstrate a "back-to-basics" approach to a refractory bifid tongue injury in a toddler.

CASE DESCRIPTION

A 1-year-old toddler with a tongue injury was unsuccessfully treated three times within a week by a surgeon in another specialty; all reconstructions were mucosal only. The case was then referred to our maxillofacial unit for proper management. On examination, the recurrent injury seemed to occur because of the patient's self-biting habit. We performed the fourth reconstruction of the tongue muscles and mucosa, and because of no dental prosthetic laboratory available in our hospital, we used transparent adhesive drapes fixed by resorbable sutures to cover the patient's anterior teeth instead of bite guards. The toddler was fed via a nasogastric tube for 1 week under 2-day antibiotic prophylaxis and routine oral care. The patient was discharged without any complications 1 week later.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The causes of repeated orofacial injuries should be identified and require particular attention to establish a proper treatment. For intraoral injuries in pediatric patients, self-biting habits should not be overlooked. The application of materials in an operating theater can help the treating clinicians improve the treatment outcomes.

Do implant-supported fixed partial prostheses improve masticatory performance in patients with unilateral posterior missing teeth?

OBJECTIVES

The purpose of this study was to determine the improvement in masticatory performance and satisfaction with chewing ability in partially edentulous patients after treatment with an implant-supported fixed partial prosthesis (ISFPP).

MATERIAL AND METHODS

This prospective study included 30 patients (mean age 59 years; 17 women) with unilateral posterior missing teeth treated with one-, two- or three-unit ISFPPs and 10 healthy individuals (mean age 36 years; 8 women) with complete natural dentition to establish the normal levels of mastication. Three variables were determined at baseline and at 3-months' follow-up in all participants: masticatory performance according to the median particle size (MPS) during freestyle mastication and unilateral mastication on each side, and satisfaction with chewing ability using a visual analog scale. Paired samples t test and Kruskal-Wallis test were used for intra-group and inter-group comparisons.

RESULTS

The MPS following freestyle mastication decreased significantly at 3 months in both groups. Significant reductions of 21%, 30%, and 42% in the MPS were obtained from unilateral mastication on the treated side after treatment with 1, 2, or 3 restorative units, respectively. Three months after ISFPP, satisfaction with chewing ability improved by 40% in the treatment group.

CONCLUSIONS

Freestyle masticatory performance may improve slightly within three months of treatment with an ISFPP and may be similar to that of subjects with complete natural dentition. Patients may obtain a 21%-38% improvement in unilateral mastication on the treated side and a 26%-54% improvement in satisfaction with chewing ability.