This study evaluated the effect of oral cancer surgery on masticatory efficiency. Masticatory efficiency was measured using the ATP absorption method. Eating ability was measured using a questionnaire. Two groups were employed as controls: The "normal occlusion group" consisted of subjects who had a complete set of natural maxillary teeth opposed to mandibular teeth, and the "unilateral occlusion group" consisted of subjects who had lost their molar and premolar teeth on one side of the mandible as a result of caries or periodontal diseases. Three treatment groups, each of 6 patients, were studied: a glossectomy group, a marginal mandibulectomy group and a segmental mandibulectomy group. There were no differences in masticatory efficiency between two control groups. Masticatory efficiencies of the three oral cancer treatment groups were lower than in the unilateral occlusion group, even 12 months after surgery. Masticatory efficiency of the glossectomy group was significantly higher 12 months after surgery compared with pre-surgery. Masticatory and eating abilities of the marginal mandibulectomy group and the segmental mandibulectomy were reduced at 3 and 6 months after surgery. The masticatory efficiency 12 months after surgery was higher in the marginal mandibulectomy group than the segmental mandibulectomy group, although the difference was not statistically significant. The self assessed eating ability 12 months after surgery was significantly higher in the marginal mandibulectomy group than the segmental mandibulectomy group. These results suggest that discontinuation of the mandible may lead patients to eat only foods that do not require a substantial amount of chewing. Hence, the quality of life of patients in the marginal mandibulectomy group was considered to be better than that in the segmental mandibulectomy group.

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Oral cancer is first treated with surgery for the patients. In most cases, it becomes difficult for these patients to perform smooth jaw movements postoperatively, causing masticatory dysfunctions, due to the mandible excision including muscles and peripheral nerves. However, it is still unknown whether the surgery affects the brain function for jaw movement in the patients. In this study, therefore, we investigated a significance of the movement-related cortical potential (MRCP) for jaw movements in the patients after the cancer surgery, to clarify the motor preparation process in the brain, as compared with healthy subjects. Eight normal subjects and seven patients with oral cancers were enrolled in the study. Experiment 1: The normal subjects were instructed to perform jaw-biting movement and hand movement, respectively. The MRCPs appeared bilaterally over the scalp approximately 1 to 2 s before the onset of muscle discharge in both movements. Experiment 2: The MRCPs appeared preoperatively in the jaw biting movement in all patients. However, the amplitudes of the MRCP decreased significantly after than before the surgery (p < 0.05). Our data indicated the dysfunction of the motor preparation process for jaw movements in the patient after the surgery, suggesting impairment of feed-forward system in the maxillofacial area.

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