Clinical Evaluation of Masticatory Performance of Pre and Post-mandibular Guidance Therapy in Hemi-mandibulectomy Patients: A Quasi-experimental Study

Abstract

Introduction: Surgical removal of the lower jaw is the most common cause of mandibular deviation due to benign or malignant neoplasms. The Palatal Guide Flange Prosthesis (PGFP) is a recommended corrective appliance to reduce this clinical manifestation. The primary goals of rehabilitation with PGFP are to train the mandibular muscles and restore a healthy occlusal relationship so that the patient can effectively control their mouth opening and closing movements. In the present article, the Masticatory Performance (MP) of patients who had undergone hemi-mandibulectomy surgery was evaluated both before and after receiving an interim PGFP. Aim: To clinically evaluate MP pre- and post-mandibular guidance therapy in hemi-mandibulectomy patients. Materials and Methods: A quasi-experimental study was conducted on patients selected from the Outpatient Department of the Department of Prosthodontics at Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India, from January 2021 to July 2022, and were included as the sample size for the study. A total of 10 samples were selected. The study design was quasi-experimental. All cancer patients had lost their mandibular continuity and showed mandibular deviation toward the affected side. PGFPs were fabricated using Heat Cure Acrylic Resin (DPI) for each participant (n=10). Corn flakes (Kellogg’s) were given to the participants to chew, and the samples were sieved using a US standard 8-mesh sieve and collected at three different time intervals: T0 (preprosthesis), T1 (8th week), and T2 (16th week post-prosthesis). Data were entered into Microsoft Excel Version 13 and analysed using IBM Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive and inferential statistics were used, including mean and standard deviation for continuous variables and frequency analysis for categorical variables. For categorical variables, a Chi-square proportion test was utilised, and MP was evaluated between T0-T1 and T0-T2. We utilised a 95% confidence interval and a p-value of less than 0.05. Results: When comparing the MP between T0, T1 and T2 time intervals, it was found that the difference in mean MP was statistically significant (p<0.05), with MP increasing from 26.2% to 43% to 61.2%, respectively. Conclusion: The occlusion restored with the guide flange prosthesis, along with continuous use over a longer period, helped correct the deviated mandible and, in turn, improved the MP.

Keywords

• mandible
• mesh sieve
• neoplasm
• prosthesis
• reconstruction