Severely Scarred Oronasal Cleft Defects in Edentulous Adults: Initial Data on the Long-Term Outcome of Telescoped Obturator Prostheses Supported by Zygomatic Implants

Abstract

Objective : Prosthetic rehabilitation of edentulous patients presenting with severely scarred oronasal cleft defects. To document the outcome of telescopic obturator prostheses attached to zygomatic implants in edentulous cleft lip and palate patients. Patients and Methods : Four edentulous patients suffering from the consequences of cleft lip and palate were selected from a cohort of 52 patients who had received zygomatic implants between 1998 and 2010. Oronasal communication had persisted and severe scars and chronic infection were noted in the cleft region. Bone grafting procedures were contraindicated due to high risk for dehiscence. For the functional support of telescopic prostheses, nine zygomatic implants and two standard dental implants had been placed. Results : The zygomatic implants and the telescopic prostheses survived an average of 62 months (37 to 99 months) and were successful. Patients' satisfaction and oral function improved (on visual analog scale and oral health impact profile). Conclusions : Telescopic obturator dentures supported by zygomatic implants represent a feasible option for the prosthetic rehabilitation of cleft lip and palate patients with severe impairments of the edentulous ridges including atrophy, scar tissue, ridge defects, oronasal communication, and chronic infection in the cleft region.

Multidimensional esthetic evaluation of patients with a cleft lip and palate wearing a maxillary partial removable dental prosthesis: A 5-year retrospective study

“…Prosthodontic rehabilitation methods include partial removable dental prostheses (PRDPs), partial fixed dental prostheses (FDPs), adhesive partial fixed dental prostheses, and implant-supported prostheses. 3,8,9 Considering the overall cost-benefit analysis, oral rehabilitation in patients with CLP requires a prosthesis capable of blocking an oronasal fistula, improving phonetic and masticatory functions, restoring cosmetics, and raising quality of life. 3,9 The MPRDP is an effective prosthodontic restorative procedure for CLP treatment.…”

“…3,8,9 Considering the overall cost-benefit analysis, oral rehabilitation in patients with CLP requires a prosthesis capable of blocking an oronasal fistula, improving phonetic and masticatory functions, restoring cosmetics, and raising quality of life. 3,9 The MPRDP is an effective prosthodontic restorative procedure for CLP treatment. It not only replaces missing teeth and compensate for tissue deficiencies that interrupt the continuity of the dental arch but can also improve the concave facial contour.…”

Maxillary Rehabilitation Using a Removable Partial Denture with Attachments in a Cleft Lip and Palate Patient: A Clinical Report

“…Oral rehabilitation in CLP patients requires an interdisciplinary view to make the prosthesis capable of blocking oronasal communication, restoring masticatory and phonetic functions, and improving cosmetics considering the overall cost/benefit analysis and gain in quality of life . Choosing between the many prosthetic rehabilitation options is based on the specific clinical situation of the patient and his/her main complaints and wishes.…”

“…Another common problem in CLP patients is deficient lip support. Removable prostheses are indicated in cases with severe bone loss that affects the lip position or when the cleft needs to be blocked . The major resistance to using RPDs for partially edentulous patients is due to cosmetic reasons, such as the visibility of metallic clamps, as well as functional concerns during speech and chewing because the prostheses are not fixed …”

“…Restorative dentistry offers several options for prosthetic rehabilitation in patients with clefts. These options include fixed partial dentures (FPDs), removable partial dentures (RPDs), adhesive FPDs, and implant‐supported dentures …”