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Letter to Editor Plastic and Aesthetic Research

A simple postoperative oral physiotherapy

aid for edentulous patients with oral

submucous fibrosis

Ankita Vastani , Anisha Maria , Nishant Chourasia , Ambika Shrivastava Gupta 2
1
1
1
1 Department of Oral and Maxillofacial Surgery, Rishiraj College of Dental Sciences and Research Centre, Bhopal 462036, Madhya Pradesh,
India.
2 Department of Prosthodontics, Rishiraj College of Dental Sciences and Research Centre, Bhopal 462036, Madhya Pradesh, India.
Address for correspondence: Dr. Ankita Vastani, Department of Oral and Maxillofacial Surgery, Rishiraj College of Dental Sciences and
Research Centre, Bhopal 462036, Madhya Pradesh, India. E‑mail: ankitavastani@gmail.com.

Sir, aimed for oral physiotherapy in patients without the use
of a mouth gag.
Oral submucous fibrosis is a chronic inflammatory disease,
which results in progressive juxta‑epithelial fibrosis of This technique involves taking impressions of the maxillary
the oral soft tissues and can cause increasing difficulty and mandibular edentulous areas using perforated trays.
in chewing, swallowing, speaking and mouth opening. Customized special trays are then fabricated and border
[1]
Management of the disease, being medical or surgical, molding is performed. Next, these trays are used to make
poses a great challenge because of the tendency to recur impressions to create heat cure denture bases with occlusal
or undergo malignant transformation. rims on the mandibular denture base [Figure 1]. These
denture bases are seated in the patient’s mouth [Figure 2]
For the management of oral submucous fibrosis, our
institution follows a protocol. This includes bilateral and vertical height of the occlusal rim can be adjusted chair
surgical release of fibrous bands, bilateral coronoidectomy, side. If more vertical height is required, then acrylic can be
extraction of all third molars and reconstruction of added on the maxillary base plate. The purpose of adding
intraoral defects using the buccal pad of fat and vigorous the occlusal rims on denture bases is to maintain mouth
postoperative oral physiotherapy with mouth gags. opening without having to rely on patient’s compliance to
actively open the mouth. The patients are supposed to wear
Application of interocclusal forces to achieve adequate these dentures when they want to perform physiotherapy.
mouth opening forms an integral part of the treatment These dentures are economical, easy to maneuver by the
of oral submucous fibrosis. The oral physiotherapy aids
[2]
that are currently in use, range from wooden spatulas
to mouth gags (such as Heister or Ferguson). Patients
with good dentition are amenable to the application of
such forces but in edentulous patients, the forces get
directly transmitted to the atrophic ridges rendering them
vulnerable to fracture and soft tissue injury. [2]
Custom made occlusal splints with grooves (for seating of
a mouth gag) have already been described as an adjunct
to oral submucous fibrosis surgery. [1‑3] In this letter, we
describe oral stents with occlusal rims without grooves, Figure 1: Heat cure acrylic resin denture bases with occlusal rims

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How to cite this article: Vastani A, Maria A, Chourasia N, Gupta AS.
A simple postoperative oral physiotherapy aid for edentulous patients
DOI: with oral submucous fibrosis. Plast Aesthet Res 2015;2:299-300.
10.4103/2347-9264.165447
Received: 23-04-2015; Accepted: 18-05-2015

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