Restricted mouth opening and its definitive management: A literature review

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. Material and Methods: 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. Results: 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. Conclusion: 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.

Repair of fractured abutment teeth under pre-existing crowns: An alternative approach.

This article describes a technique for repair of abutment tooth which fractured during removal of a provisional restoration before bisque trial. The technique uses plastic templates to fabricate new composite core foundation for the existing crowns. This technique helps the dentist to rebuild the core in a single appointment.

Custom sectional impression trays with interlocking type handle for microstomia patients.

Making impressions in microstomia patients is often cumbersome. A modification of standard impression procedure is often necessary while treating such patients. This article describes the fabrication of a custom sectional impression tray with interlocking type of a handle for definitive impression procedures in a microstomia patient.

Assessment of chair side techniques for composite resin restoration--a survey.

The purpose of this survey was to assess the awareness of dental practitioners relating to chair side techniques in restoring teeth with light cure composite. The survey package consisted of a consent form, a leaflet stating the rationale and purpose of the survey and the questionnaire. Randomised sample of dental surgeons in practice was selected. The collected data was then analysed. A 52% response was obtained. Gross deficiencies in practice technique were observed, especially related to parameters like isolation, etching, bond and composite application and finishing of the restoration. Significantly individual assessment of problems by dental practitioners was found to be different from objective rationale. It is suggested that adequate and periodic re-evaluation of techniques must be made by the general dental practitioners, through continuing dental education or workshops so as to achiEve optimum quality.