A Collapsible Partial Denture for a Patient with Limited Mouth Opening Induced by Scleroderma: A Clinical Report

Abstract

A limited opening of the mouth is defined as microstomia. Microstomia is caused by burns, postoperative head and neck trauma, radiotherapy, or scleroderma. The prosthetic treatment of microstomia presents particular challenges, and patients often complain of an inability to insert or remove the prosthesis. The cause and severity of microstomia can influence the approach to treatment. Different treatment methods have been suggested, including the fabrication of two-piece partial dentures. This clinical report describes the construction of a sectional impression tray and a collapsed partial denture using a hinge attachment for a patient with microstomia.

Prosthetic Rehabilitation of Microstomia Patients: A Systematic Review of Published Case Reports and Case Series

“…Thirteen (38.2%) of the 34 reported microstomia cases were due to post-surgical complications, [2][3][4]9,12,17,18,[23][24][25][26]28,34 and 14 (41.1%) cases were due to scleroderma/systemic sclerosis, 5,6,8,10,[13][14][15][19][20][21][22]27,29,32 . Two cases of burn injuries, 7,11 and, one case each of Freeman-Sheldon syndrome, 30 muscular dystrophy, 31 and congenital maxillomandibular syngnathia, 33 and one case of coexisting systemic lupus erythematosus and scleroderma 16 .…”

“…Eight cases involved the use of pre-prosthetic surgical and/or non-surgical therapy to aid in the placement of the prosthesis. 2,6,10,30,33 The most frequently used impression technique was the sectional impression tray [8 (23.5%) cases], 5,12,14,22,23,27,31,32 followed by flexible, folded, and semi-rigid impression tray [4 (11.7%) cases]. 3,7,12,19 Other impression techniques included the use of a plasticized intermediary liner to make the impression [1 (2.9%) case] 25 and recording of the impression via manually dispensing a putty-type impression material intra-orally [1 (2.9%) case].…”

“…[2][3][4] Other common causes of acquired microstomia include perioral burns and connective tissue disorders, such as scleroderma. 5 Acquired microstomia cases due to connective tissue disorders are progressive in nature and lead to significant interference in day-to-day activities, such as speech, deglutition, and oral hygiene maintenance. Microstomia also complicates endotracheal intubation and increases the risk for aspiration.…”

Prosthetic Rehabilitation on Edentulous Patients with Microstomia: About Three Cases

“…In the other hand, this condition presents a challenge for the clinician through all the prosthetic treatment stages. It may be impossible to make impressions and fabricate dentures using conventional methods, so a modified denture approach, depending on the cause and severity of microstomia, must be employed [7–9].…”

Sectional Mandibular Complete Denture for a Total Maxillectomy Patient With Trismus: A Clinical Report

“…Design of a sectional denture should provide satisfactory function and simplicity of insertion/removal of large prostheses ( 6 ). Different impression methods and sectional denture fabrication techniques have been described for patients with limited mouth openings, including hinges ( 7 , 8 , 9 , 10 ), pin attachments ( 8 , 11 ), swinglock attachments ( 12 , 13 ), cast locking recesses ( 14 ), stud attachments ( 7 , 15 ), telescopic systems ( 13 , 16 ), clasps ( 17 ), and magnetic attachments ( 6 , 18 , 19 , 20 , 21 ). Yenisey et al ( 10 ) have used a micro-anchor as a secondary labial lock to prevent denture deflection during chewing.…”