顎顔面補綴
Online ISSN : 2435-0389
Print ISSN : 0389-4045
認定医症例報告
下顎辺縁切除患者に顎義歯の設計変更で対応した症例
荻野 洋一郎
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ジャーナル フリー

2021 年 44 巻 2 号 p. 58-63

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An 82-year-old female visited our department after marginal mandibulectomy in the left premolar and molar area due to squamous cell carcinoma. She was completely edentulous in the maxilla and was categorized as Kennedy ClassⅡ in the mandible. She was rehabilitated with a complete denture and a unilateral free-end removable partial denture (RPD). However, she complained of pain in the resected area and avoided using her mandibular RPD, followed by tongue-mucosa adhesion and a phonetic problem. After surgical intervention, instability of the RPD was still observed due to mandibular morphology after marginal mandibulectomy. To solve this problem, a four-unit fixed partial denture was changed into two single crowns (porcelain fused to metal crowns) with guide planes and an RPD for Kennedy ClassⅡ modification was fabricated. This RPD provided stability and improved her oral functions. Although the clinical course looked fine, wear of the artificial teeth depending on the material properties was associated with denture instability and occlusal problem. After a 3-year observation period, a maxillary denture with metal cusp and palatal plate was fabricated, resulting in better stability.
This case report demonstrated that modifying the RPD design contributed to stability in a patient after marginal mandibulectomy.
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