Microstomia: Difficult Proposition to Rehabilitate

Introduction: The rehabilitation of microstomia patientspresents difficulties during fabrication of denture as themaximal mouth opening is inadequate. This condition mayresult from the surgical treatment of orofacial cancer, cleft lip,trauma, burns, Plummer–Vinson syndrome or scleroderma.The reduced mouth opening also leads to difficulty in speech,mastication and psychological problems secondary to facialdisfigurement.Case report: It is often difficult to apply conventional clinicalprocedures to fabricate prosthesis for patients who demonstratelimited mouth opening, since it is difficult to follow theprotocol of fabrication of prosthesis and also insertion andremoval of one-piece prosthesis into the oral cavity. Thepresent case report focuses on rehabilitation of microstomiausing sectional prosthesis and intraoral magnets with whichenabled easier and competent removal and insertion by thepatient.Conclusion: The sectional denture attached by the magnetcan be more comfortably removed and inserted by the patientwith reduced mouth opening. It is simple and cost-effectivemethod for rehabilitation of microstomia patient.

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report

Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.