PURPOSE: The purpose of this paper is to systematically review all the prosthetic techniques that have been used in the oral rehabilitation of patients with microstomia.
MATERIALS AND METHODS: Data sources, including PubMed, Google Scholar, SCOPUS and Web of Science, were searched for case reports and case series published through September 2017. Three investigators reviewed and verified the extracted data. Only case reports and case series on prosthetic rehabilitation in microstomia patients published in the English language were considered eligible.
RESULTS: A total of 212 records were identified from the database search. Forty duplicate records were removed. The remaining 172 articles were assessed for eligibility, and 139 articles were removed because they did not satisfy the inclusion criteria. A total of 34 cases (including 32 case reports and 1 case series) were finally included in the qualitative analysis. The review revealed the use of a modified impression technique with flexible and sectional trays to record impressions in patients with microstomia. Modified forms of oral prostheses ranging from sectional, flexible, collapsible and hinged dentures to implant-supported prosthesis were fabricated to overcome the limited mouth opening. The success of the prosthetic technique primarily depended on the extent of the microstomia and the nature of the cause of the microstomia.
CONCLUSION: Even though the patient acceptance of the prosthetic techniques summarized in the systematic review were high, long-term success rates for each option could not be assessed because of the short follow-up time in most of the included case reports and series.
AIM: To evaluate resting tongue position in recently extracted and long term completely edentulous patients, and to evaluate the efficacy of achieving retracted tongue position by simple modification in complete denture along with certain tongue exercises.
MATERIALS AND METHODS: A total of 62 study subjects were classified into two groups based on duration of edentulousness. Group A: Recently extracted completely edentulous subjects (<1 year), Group B: Long term completely edentulous subjects (>1-10 year). The patients with retracted tongue position were subjected to a simple modification in complete denture along with inclusion of certain tongue exercises. After eight months patients were recalled and evaluated. The data was analysed using SPSS statistical tests like mean, standard deviation, proportion, Chi square test and McNemar Test.
RESULTS: Among the study subjects, 54.9% had retracted tongue position. Group B showed high proportion of retracted tongue position (68.8%) as compared to Group A. After the intervention, 42.8% study subjects gained normal resting tongue position.
CONCLUSION: Long term completely edentulous subjects presented retracted tongue position in higher percentage when compared to the recently extracted group. The interventional method employed for the subjects with retracted tongue position, played a significant role to assume normal resting tongue position and showed improvement in denture stability and retention.
Method: Maxillary CBCT images of two-hundred-and-fifty-seven consecutive patients (163 men, 94 women, mean age 42 years) were analyzed. Samples were later divided into dentate (n = 142) and posteriorly edentulous (n = 115) jaws. Using both alveolar ridge and tooth location as reference points, the distance and diameter of IA were assessed.
Result: The IA was seen in 63.7% of all sinuses with 68.2% in dentate and 62.4% in edentulous. Mean distance and diameter of IA across the posterior tooth locations were 17.9 ± 3.0 mm and 1.4 ± 0.5 mm (dentate) and 15.1 ± 3.0 mm and 1.0 ± 0.5 mm (posteriorly edentulous), respectively. In each sample, there were no significant differences in distance-alveolar ridge and no significant correlations in diameter-tooth location. A statistically significant Pearson coefficient correlation between diameter and distance in dentate state was observed (r = -0.6).
Conclusion: This study reveals that dentate maxillary jaws present larger diameters as compared to posteriorly edentulous jaws, although the IA course remains the same. As these canal structures contain neurovascular bundles with diameters that may be large enough to cause clinically substantial complications, a thorough pre-surgical planning is therefore highly advisable.