Remission Verified in Denture Maladjustment Patient by Assessing Post-meal Impression: A Case Report and Narrative Consideration

Patient: A 63-year-old woman who had complaints with maxillary and mandibular complete dentures resulting in masticatory deficiency was referred to our hospital in March 2002.The patient was classified as class IV with the American College of Prosthodontists' classification system. The existing dentures were marked as 30/100 with the assessment system of Sato et al. The horizontal jaw relation was extremely unstable with various tapping points. The patient was under the impression that her oral condition was the major cause of dissatisfaction with her dentures. The condition was diagnosed as masticatory deficiency caused by unstable jaw relation and denture maladjustment. A prosthetic and psychosomatic approach was planned, i. e. treatment dentures, remedy for unsuitable horizontal jaw relation, and receptive dialogue and attention to be a hearer, and remedy for denture maladjustment.Nineteen control adjustments were counted from the first visit and the final dentures were delivered in April 2003.Two months after the delivery, the patient became positive toward taking meals and significant improvement was observed in the patient's subjective assessment of aftermeal impressions. Discussion: Long-term instability of horizontal mandibular position caused by inadequate dentures had induced self-hatred of a punctual and honest patient who was convinced that her oral condition was the reason for denture maladjustment. Appropriate prosthetic therapy and receptive correspondence and assurance resulted in remission of the symptoms. Conclusion: In addition to appropriate prosthetic and psychosomatic therapy approach, the effectiveness of post-meal impression for assessing improvement of symptoms was shown to be important.