Kumar Bhushan, Fernandes Aquaviva, Sandhu Prabhdeep Kaur
Department of Prosthodontics, Graded Specialist, Army Dental Corps, India.
Department of Prosthodontics, Private Practitioner, Goa, India.
Indian J Dent Res. 2018 Mar-Apr;29(2):217-224. doi: 10.4103/ijdr.IJDR_544_16.
This review was intended to discuss the various possible modifications suggested in the literature for prosthetic steps and surgical corrective procedures in nonresponding or complicated cases during rehabilitation of patients with restricted mouth opening.
: Medline, PubMed, and Google were searched electronically for articles using keywords: microstomia and treatment options for restricted mouth opening. The various articles on prosthodontic rehabilitation in microstomia were segregated. From these, various modifications in the prosthetic steps were reviewed.
: Oral hygiene maintenance is difficult for patient either due to limited access or due to associated lack of manual dexterity, so dental decay and periodontal problems are more extensive in such patients; hence, tooth loss is a common finding. All prosthetic procedures require wide mouth opening to carry out various steps, starting from tray placement during impression making to the final prosthesis insertion, especially removable prosthesis. Various prosthetic modifications given by authors are included in this review for each step in prosthodontic management. A total of eight stock tray designs, 12 custom tray designs, and 17 removable prosthesis designs are discussed along with fixed (either tooth-supported or implant-supported) and maxillofacial prosthesis. However, some patients require surgical intervention also for the correction of microstomia either for function or for esthetic purpose before prosthetic rehabilitation and are also enumerated here.
Among all prosthetic restorative options, removable prosthesis is most difficult for dentist to fabricate as conventional methods are either very difficult or impossible to apply. To get a more accurate final prosthesis, we need to modify these steps according to the existing case. Several modifications available are discussed here which can help while managing these patients.
本综述旨在讨论文献中针对张口受限患者康复过程中无反应或复杂病例的修复步骤及手术矫正程序所提出的各种可能的改进方法。
通过电子方式在Medline、PubMed和谷歌上搜索使用关键词“小口畸形与张口受限的治疗选择”的文章。对有关小口畸形修复康复的各种文章进行了分类。从中回顾了修复步骤中的各种改进方法。
由于口腔进入受限或伴有手部灵活性不足，患者难以维持口腔卫生，因此这类患者的龋齿和牙周问题更为广泛；因此，牙齿缺失是常见现象。所有修复程序都需要张口较大才能进行从印模制取时放置托盘到最终义齿戴入的各个步骤，尤其是可摘义齿。本综述纳入了作者针对修复治疗管理各步骤给出的各种修复改进方法。共讨论了八种成品托盘设计、十二种定制托盘设计和十七种可摘义齿设计，以及固定（牙支持或种植体支持）和颌面修复体。然而，一些患者在修复康复前还需要进行手术干预以矫正小口畸形，无论是出于功能还是美观目的，此处也进行了列举。
在所有修复性修复选择中，可摘义齿对牙医来说最难制作，因为传统方法要么非常困难要么无法应用。为了获得更精确的最终义齿，我们需要根据具体病例修改这些步骤。这里讨论了几种可用的改进方法，在管理这些患者时可能会有所帮助。
