Economical Prosthodontic Management of Microstomia Patient with Hinge Denture -
A CLINICL REPORT WITH CLASSIFICATION SYSTEM
Keywords:
Microstomia, Split denture, Sectional denture
Abstract
Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function and esthetics. Prosthodontic management of edentulous patients with microstomia is a challenging task. Use of conventional methods for recording an impression and fabricating prosthesis is not effective in such patients. To fabricate well-fitting prosthesis, accuracy of impression recording important anatomic landmarks is essential. Formation of an exacting custom tray and diagnostic cast is critical for final impression accuracy. Provision of a well-fitting prosthesis in microstomia patient will restore esthetics, comfort, and function with oral and systemic patient wellbeing. This paper presents a case report of managing an edentulous microstomia patient with sectional removable prosthesis.
References
1. Sae Hwi Ki, Gang Yeon Jo, Jinmyung Yoon, Matthew Seung Suk Choi “Reconstruction of microstomia considering their functional status,” Archives of Craniofacial Surgery, Vol.21 No.3, 161-165, 2020
2. Nitin Deora, Shweta Bindra and Swati Aggarwal, “Prosthodontic Management Of Microstomia With Split Denture- A Case Report” International Journal of Recent Scientific Research Research Vol. 7, Issue, 10, pp. 14025-14028, October, 2016
3. E. King and J. Owens, “Flexible and sectional complete dentures with magnetic retention for a patient with microstomia– a case report,” Dental update., vol. 43, no. 3, pp. 212- 213, 2016.
4. I. Tulunoglu, M. H. Lee, M. L. Taifur, and O. Tulunoglu, “Restoring masticatory function in a patient with severe microstomia using rapid prototyped mesh and a custommade hinge and swing-lock prosthesis,” The Journal of Prosthetic Dentistry, vol. 119, no. 6, pp. 887–892, 2018.
5. Cura C, Cotert HS, User A. Fabrication of a sectional impression tray and sectional complete denture for a patient with microstomia and trismus: A clinical report. J Prosthet Dent 2003;89:540‑3.
6. Baker PS, Brandt RL, Boyajian G. Impression procedure for patients with severely limited mouth opening. J Prosthet Dent 2000;84:241‑4.
7. Satpathy A, Gujjari AK. Complete denture in a microstomia patient. J Clin Diagn Res 2015;9:ZD16‑8.
8. M. J. Garnett, F. S. Nohl, and S. C. Barclay, “Management of patients with reduced oral aperture and mandibular hypomobility (trismus) and implications for operative dentistry,” British Dental Journal, vol. 204, no. 3, pp. 125–131, 2008.
9. Martins WD, Westphalen FH, Westphalen VP. Microstomia caused by swallowing of caustic soda: report of a case. J Contemp Dent Pract 2003;4:91-9.
10. Seel C, Hager HD, Jauch A, Tariverdian G, Zschocke J. Survival up to age 10 years in a patient with partial duplication 6q: case report and review of the literature. Clin Dysmorphol 2005; 14:51-4.
11. H. Malkawi and M. Tarawneh, “The whistling face syndrome, or craniocarpotarsal dysplasia. Report of two cases in a father and son and review of the literature,” Journal of Pediatric Orthopaedics, vol. 3, no. 3, pp. 364–369, 1983.
12. Gulses A. Microstomia: A Rare but Serious Oral Manifestation of Inherited Disorders. Advances in the Study of Genetic Disorders 2011; 449-72.
13. De Benedittis M, Petruzzi M, Favia G, Serpico R. Oro-dental manifestations in Hallopeau-Siemens-type recessive dystrophic epidermolysis bullosa. Clin Exp Dermatol 2004; 29:128-32.
14. Aren G, Yurdabakan Z, Ozcan I. Freeman-Sheldon syndrome: a case report. Quintessence Int 2003;34:307- 10.
15. Millner MM, Mutz ID, Rosenkranz W. Whistling face syndrome. A case report and literature review. Acta Paediatr Hung 1991;31:279-89.
16. Lo IF, Roebuck DJ, Lam ST, Kozlowski K. Burton skeletal dysplasia: the second case report. Am J Med Genet 1998;79:168-71.
17. Cakan M, Aktay Ayaz N, Keskindemirci G, Onan SH, Akoz Saydam F. A case of Kawasaki disease with severe lip and oral mucosa involvement complicated with microstomia and cor¬rected with surgery. Arch Rheumatol 2017;33:238-40.
18. Zweifel CJ, Guggenheim M, Jandali AR, Altintas MA, Kunzi W, Giovanoli P. Management of microstomia in adult burn pa¬tients revisited. J Plast Reconstr Aesthet Surg 2010;63:e351-7.
19. P. Sinavarat and C. Anunmana, “Sectional collapsible complete removable dental prosthesis for a patient with microstomia,” The Journal of Prosthetic Dentistry, vol. 114, no. 5,pp. 627–632, 2015.
20. H. Malkawi and M. Tarawneh, “The whistling face syndrome, or craniocarpotarsal dysplasia. Report of two cases in a father and son and review of the literature,” Journal of Pediatric Orthopaedics, vol. 3, no. 3, pp. 364–369, 1983.
21. K. N. Nguyen, I. Semenov, B. Blasiole, J. G. Robison, and D. H. Chi, “Congenital microstomia in a neonate with impending respiratory compromise,” Case reports in Anesthesiology, vol. 2014, Article ID 739463, 3 pages, 2014.
22. P. Sinavarat and C. Anunmana, “Sectional collapsible complete removable dental prosthesis for a patient with microstomia,” The Journal of Prosthetic Dentistry, vol. 114, no. 5, pp. 627–632, 2015.
23. Koymen R, Gulses A, Karacayli U, Aydintug YS. Treatment of microstomia with commissuroplasties and semidynamic acrylic splints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(4):503-07.
24. D. A. Givan, W. A. AuClair, J. C. Seidenfaden CDT, and J. Paiva, “Sectional impressions and simplified folding complete denture for severe microstomia,” Journal of Prosthodontics, vol. 19, no. 4, pp. 299–302, 2010.
25. Maria S. Abbasi, Naseer Ahmed, Adil Bin Irfan, Samar Al-Saleh, Tariq Abduljabbar and Fahim Vohra, “Management of Edentulous Microstomia Patient: A Case Report and Classification System” Hindawi Case Reports in Dentistry , Volume 2022, Article ID 2686983,
5 pages. https://doi.org/10.1155/2022/2686983
26. T. J. McGarry, A. Nimmo, J. F. Skiba, R. H. Ahlstrom, C. R. Smith, and J. H. Koumjian, “Classification system for complete edentulism,” Journal of Prosthodontics, vol. 8, no. 1, pp. 27–39, 1999.
27. Ichimura K, Tanaka T: Trismus in patients with malignant tumors in the head and neck. J Laryngol Otol 1993;107:1017-1020
28. Werner R: Treatment of trismus following radiotherapy in nasopharyngeal cancer. Singapore Med J 1974;15:64-68
29. Connie TA, Carlow DL, Stevenson Moore P: The vancover microstomia orthosis. J Prosthet Dent 1989;61:476-483
30. Koumjian JH, Firtell DN: Prosthesis to control microstomia. J Prothet Dent 1990;64:502-503
31. Khan Z, Banis JC: Oral commissure expansion prothesis. J Prosthet Dent 1992;67:383-385
32. Heasman PA, Thomason JM, Robinson JG: The provision of protheses for patients with severe limitation in opening the mouth. Br Dent J 1994;176:171-174
33. Naylor WP, Manor RC: Fabrication of a flexible prothesis for the edentulous scleroderma patient with microstomia. J Prosthet Dent 1983;50:536-538
34. Suzuki Y, Abe M, Hosoi T et al: Sectional collapsed denture for a partially edentulous patient with microstomia: a clinical report. J Prosthet Dent 2000;84:256-259
35. Conroy B, Reitzik M: Prosthetic restoration in microstomia. J Prosthet Dent 1971;26:324-327
36. Winkler S, Wongthai P, Wazney JT: An improved split-denture technique. J Prosthet Dent 1984;51:276-279
37. Curo C, Cotert HS, User A: Fabrication of sectional impression tray and sectional complete denture for a patient with microstomia and trismus. A clinical report J Prosthet Dent
2003;89:540-543
38. Benetti R, Zupi A, Toffanin A: Prosthetic rehabilitation for a patient with microstomia: a clinical report. J Prosthet Dent 2004;92:322-327
39. Watanabe I, Tanaka Y, Ohkubo C, et al: Application of cast iron-platinum magnetic attachment to sectional collapsed complete dentures for an edentulous patient with microstomia: a clinical report. J Prosthet Dent 2002;88:73-77
40. Al Hadi LA: A simplified technique for prosthetic treatment of microstomia in a patient with scleroderma: a case report. Quintessence Int 1994;25:531-533
41. Cheng AC, Wee AG, Morrison D, et al: Hinged mandibular removable complete denture for post-mandibulectomy patients. J Prosthet Dent 1999;82:103-106
42. Wahle JJ, Gardner LK, Fiebiger M: The mandibular swing lock complete denture for patients with microstomia. J Prosthet Dent 1992;68:523-527
43. Geckili O, Cilingir A, Bilgin T: Impression procedures and construction of a sectional denture for a patient with microstomia. A clinical report. J Prosthet Dent 2006;96:387-390
44. Ohkubo C, Maeda Y, Watanabe I, et al: Application of cast iron-platinum keeper to collapsed denture for a patient with constricted oral opening: a case report. JSMAD 2002;11:
112-117
45. Matsumura H, Kawasaki K: Magnetically connected removable sectional denture for a maxillary defect with severe undercut: a clinical report. J Prosthet Dent 2000;84:22-26
46. Dikdas I, Koksal T, Kazzazoglu E: Fabricating sectional collapsible complete dentures for an edentulous patient with microstomia induced by scleroderma. Quintessence Int 2007;38:15-22
47. MacCord JF, Tyson KW, Blair IS: A sectional complete denture for a patient with microstomia. J Prosthet Dent 1989;61:645-647
48. Nair CK, Sivagami G, Kunnekel AT, Naidu ME. Dynamic commissural splint. Indian J Dent Res 2008;19:165–8.
49. Bedard JF, Thongthammachat S, Toljanic JA. Adjunctive commissure splint therapy: a
revised approach. J Prosthet Dent 2003;89:408–11.
50. Al-Hadi LA, Abbas H. Treatment of an edentulous patient with surgically induced
microstomia: a clinical report. J Prosthet Dent 2002; 87(4):423–6.
51. Yenisey M et al. A prosthodontic management alternative for scleroderma patient. J Oral Rehabil 2005; 32(9):696- 700.
52. Sharma A, Arora P, Wazir SS. Hinged and sectional complete denture for restricted mouth opening: a case report and review. Contemp Clin Dent 2013;4(1):74–7
53. Bachhav VC, Aras MA. A simple method for fabricating sectional impression trays for
making definitive impressions in patients with microstomia. Eur J Dent 2012; 6:244-7.
2. Nitin Deora, Shweta Bindra and Swati Aggarwal, “Prosthodontic Management Of Microstomia With Split Denture- A Case Report” International Journal of Recent Scientific Research Research Vol. 7, Issue, 10, pp. 14025-14028, October, 2016
3. E. King and J. Owens, “Flexible and sectional complete dentures with magnetic retention for a patient with microstomia– a case report,” Dental update., vol. 43, no. 3, pp. 212- 213, 2016.
4. I. Tulunoglu, M. H. Lee, M. L. Taifur, and O. Tulunoglu, “Restoring masticatory function in a patient with severe microstomia using rapid prototyped mesh and a custommade hinge and swing-lock prosthesis,” The Journal of Prosthetic Dentistry, vol. 119, no. 6, pp. 887–892, 2018.
5. Cura C, Cotert HS, User A. Fabrication of a sectional impression tray and sectional complete denture for a patient with microstomia and trismus: A clinical report. J Prosthet Dent 2003;89:540‑3.
6. Baker PS, Brandt RL, Boyajian G. Impression procedure for patients with severely limited mouth opening. J Prosthet Dent 2000;84:241‑4.
7. Satpathy A, Gujjari AK. Complete denture in a microstomia patient. J Clin Diagn Res 2015;9:ZD16‑8.
8. M. J. Garnett, F. S. Nohl, and S. C. Barclay, “Management of patients with reduced oral aperture and mandibular hypomobility (trismus) and implications for operative dentistry,” British Dental Journal, vol. 204, no. 3, pp. 125–131, 2008.
9. Martins WD, Westphalen FH, Westphalen VP. Microstomia caused by swallowing of caustic soda: report of a case. J Contemp Dent Pract 2003;4:91-9.
10. Seel C, Hager HD, Jauch A, Tariverdian G, Zschocke J. Survival up to age 10 years in a patient with partial duplication 6q: case report and review of the literature. Clin Dysmorphol 2005; 14:51-4.
11. H. Malkawi and M. Tarawneh, “The whistling face syndrome, or craniocarpotarsal dysplasia. Report of two cases in a father and son and review of the literature,” Journal of Pediatric Orthopaedics, vol. 3, no. 3, pp. 364–369, 1983.
12. Gulses A. Microstomia: A Rare but Serious Oral Manifestation of Inherited Disorders. Advances in the Study of Genetic Disorders 2011; 449-72.
13. De Benedittis M, Petruzzi M, Favia G, Serpico R. Oro-dental manifestations in Hallopeau-Siemens-type recessive dystrophic epidermolysis bullosa. Clin Exp Dermatol 2004; 29:128-32.
14. Aren G, Yurdabakan Z, Ozcan I. Freeman-Sheldon syndrome: a case report. Quintessence Int 2003;34:307- 10.
15. Millner MM, Mutz ID, Rosenkranz W. Whistling face syndrome. A case report and literature review. Acta Paediatr Hung 1991;31:279-89.
16. Lo IF, Roebuck DJ, Lam ST, Kozlowski K. Burton skeletal dysplasia: the second case report. Am J Med Genet 1998;79:168-71.
17. Cakan M, Aktay Ayaz N, Keskindemirci G, Onan SH, Akoz Saydam F. A case of Kawasaki disease with severe lip and oral mucosa involvement complicated with microstomia and cor¬rected with surgery. Arch Rheumatol 2017;33:238-40.
18. Zweifel CJ, Guggenheim M, Jandali AR, Altintas MA, Kunzi W, Giovanoli P. Management of microstomia in adult burn pa¬tients revisited. J Plast Reconstr Aesthet Surg 2010;63:e351-7.
19. P. Sinavarat and C. Anunmana, “Sectional collapsible complete removable dental prosthesis for a patient with microstomia,” The Journal of Prosthetic Dentistry, vol. 114, no. 5,pp. 627–632, 2015.
20. H. Malkawi and M. Tarawneh, “The whistling face syndrome, or craniocarpotarsal dysplasia. Report of two cases in a father and son and review of the literature,” Journal of Pediatric Orthopaedics, vol. 3, no. 3, pp. 364–369, 1983.
21. K. N. Nguyen, I. Semenov, B. Blasiole, J. G. Robison, and D. H. Chi, “Congenital microstomia in a neonate with impending respiratory compromise,” Case reports in Anesthesiology, vol. 2014, Article ID 739463, 3 pages, 2014.
22. P. Sinavarat and C. Anunmana, “Sectional collapsible complete removable dental prosthesis for a patient with microstomia,” The Journal of Prosthetic Dentistry, vol. 114, no. 5, pp. 627–632, 2015.
23. Koymen R, Gulses A, Karacayli U, Aydintug YS. Treatment of microstomia with commissuroplasties and semidynamic acrylic splints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(4):503-07.
24. D. A. Givan, W. A. AuClair, J. C. Seidenfaden CDT, and J. Paiva, “Sectional impressions and simplified folding complete denture for severe microstomia,” Journal of Prosthodontics, vol. 19, no. 4, pp. 299–302, 2010.
25. Maria S. Abbasi, Naseer Ahmed, Adil Bin Irfan, Samar Al-Saleh, Tariq Abduljabbar and Fahim Vohra, “Management of Edentulous Microstomia Patient: A Case Report and Classification System” Hindawi Case Reports in Dentistry , Volume 2022, Article ID 2686983,
5 pages. https://doi.org/10.1155/2022/2686983
26. T. J. McGarry, A. Nimmo, J. F. Skiba, R. H. Ahlstrom, C. R. Smith, and J. H. Koumjian, “Classification system for complete edentulism,” Journal of Prosthodontics, vol. 8, no. 1, pp. 27–39, 1999.
27. Ichimura K, Tanaka T: Trismus in patients with malignant tumors in the head and neck. J Laryngol Otol 1993;107:1017-1020
28. Werner R: Treatment of trismus following radiotherapy in nasopharyngeal cancer. Singapore Med J 1974;15:64-68
29. Connie TA, Carlow DL, Stevenson Moore P: The vancover microstomia orthosis. J Prosthet Dent 1989;61:476-483
30. Koumjian JH, Firtell DN: Prosthesis to control microstomia. J Prothet Dent 1990;64:502-503
31. Khan Z, Banis JC: Oral commissure expansion prothesis. J Prosthet Dent 1992;67:383-385
32. Heasman PA, Thomason JM, Robinson JG: The provision of protheses for patients with severe limitation in opening the mouth. Br Dent J 1994;176:171-174
33. Naylor WP, Manor RC: Fabrication of a flexible prothesis for the edentulous scleroderma patient with microstomia. J Prosthet Dent 1983;50:536-538
34. Suzuki Y, Abe M, Hosoi T et al: Sectional collapsed denture for a partially edentulous patient with microstomia: a clinical report. J Prosthet Dent 2000;84:256-259
35. Conroy B, Reitzik M: Prosthetic restoration in microstomia. J Prosthet Dent 1971;26:324-327
36. Winkler S, Wongthai P, Wazney JT: An improved split-denture technique. J Prosthet Dent 1984;51:276-279
37. Curo C, Cotert HS, User A: Fabrication of sectional impression tray and sectional complete denture for a patient with microstomia and trismus. A clinical report J Prosthet Dent
2003;89:540-543
38. Benetti R, Zupi A, Toffanin A: Prosthetic rehabilitation for a patient with microstomia: a clinical report. J Prosthet Dent 2004;92:322-327
39. Watanabe I, Tanaka Y, Ohkubo C, et al: Application of cast iron-platinum magnetic attachment to sectional collapsed complete dentures for an edentulous patient with microstomia: a clinical report. J Prosthet Dent 2002;88:73-77
40. Al Hadi LA: A simplified technique for prosthetic treatment of microstomia in a patient with scleroderma: a case report. Quintessence Int 1994;25:531-533
41. Cheng AC, Wee AG, Morrison D, et al: Hinged mandibular removable complete denture for post-mandibulectomy patients. J Prosthet Dent 1999;82:103-106
42. Wahle JJ, Gardner LK, Fiebiger M: The mandibular swing lock complete denture for patients with microstomia. J Prosthet Dent 1992;68:523-527
43. Geckili O, Cilingir A, Bilgin T: Impression procedures and construction of a sectional denture for a patient with microstomia. A clinical report. J Prosthet Dent 2006;96:387-390
44. Ohkubo C, Maeda Y, Watanabe I, et al: Application of cast iron-platinum keeper to collapsed denture for a patient with constricted oral opening: a case report. JSMAD 2002;11:
112-117
45. Matsumura H, Kawasaki K: Magnetically connected removable sectional denture for a maxillary defect with severe undercut: a clinical report. J Prosthet Dent 2000;84:22-26
46. Dikdas I, Koksal T, Kazzazoglu E: Fabricating sectional collapsible complete dentures for an edentulous patient with microstomia induced by scleroderma. Quintessence Int 2007;38:15-22
47. MacCord JF, Tyson KW, Blair IS: A sectional complete denture for a patient with microstomia. J Prosthet Dent 1989;61:645-647
48. Nair CK, Sivagami G, Kunnekel AT, Naidu ME. Dynamic commissural splint. Indian J Dent Res 2008;19:165–8.
49. Bedard JF, Thongthammachat S, Toljanic JA. Adjunctive commissure splint therapy: a
revised approach. J Prosthet Dent 2003;89:408–11.
50. Al-Hadi LA, Abbas H. Treatment of an edentulous patient with surgically induced
microstomia: a clinical report. J Prosthet Dent 2002; 87(4):423–6.
51. Yenisey M et al. A prosthodontic management alternative for scleroderma patient. J Oral Rehabil 2005; 32(9):696- 700.
52. Sharma A, Arora P, Wazir SS. Hinged and sectional complete denture for restricted mouth opening: a case report and review. Contemp Clin Dent 2013;4(1):74–7
53. Bachhav VC, Aras MA. A simple method for fabricating sectional impression trays for
making definitive impressions in patients with microstomia. Eur J Dent 2012; 6:244-7.
Published
2024-07-13
How to Cite
Dutta, A., Rohit Kumar Singh, & Suyog Pradhan. (2024). Economical Prosthodontic Management of Microstomia Patient with Hinge Denture - . UNIVERSITY JOURNAL OF DENTAL SCIENCES, 10(2). https://doi.org/10.21276//ujds.2024.10.2.14
Section
Case Reports
