Increasing tongue pressure with CAD/CAM palatal augmentation plate for tongue cancer patients with glossectomy

This prospective study evaluated the impact of computer-aided design/manufacturing (CAD/CAM) palatal augmentation prostheses (PAPs) rehabilitation on maximum tongue pressure in tongue cancer patients underwent glossectomy.

Twelve patients (7 men, 5 women; mean age 53.2 years) with T1N0M0 or T2N0M0 tongue cancer that had undergone a type IIIa glossectomy without radiotherapy or chemotherapy were enrolled. All the participants had intact palates for good retention of PAP. Six weeks postoperatively, maxillary arches were scanned with an intraoral scanner; PAPs were digitally designed to lower the palatal vault utilizing CAD and then were fabricated from biocompatible PMMA via 3D printing and delivered. Patients wore the PAP daily and performed tongue-PAP contact exercises for at least four hours per day over six months. Maximum tongue pressure was measured using the Iowa Oral Performance Instrument before PAP delivery and after six months of rehabilitation. Statistical analysis was conducted using ANOVA with p < 0.05 considered significant.

Mean maximum tongue pressure increased from 16.93 ± 13.16 kPa pre-rehabilitation to 26.93 ± 15.60 kPa post-rehabilitation (median: 11.9 to 21.9 kPa). ANOVA showed a significant improvement (F = 5.31, p = 0.0038).

CAD/CAM PAP rehabilitation significantly improved the maximum tongue pressure in glossectomy patients, suggesting potential benefits for oral-phase swallowing efficiency. Early postoperative delivery through a digital workflow minimized tongue-palate distance, enabling prompt exercises, and accelerating functional recovery. This approach represents an innovative rehabilitation strategy. Integration of pressure sensors into PAPs could enable real-time monitoring of tongue activity, expanding their role as dynamic training devices.