Dental management of patients with microstomia: a review of the literature and update on the treatment / Manejo clínico odontológico del paciente con microstomia: una revisión de la literatura y puesta al día

Difficulty in dental management is one of the factors that characterize the patient that requires special care in dentistry. One of the clinical conditions that make dental treatment particularly complex is microstomia. Microstomia is defined as a small and insufficient oral aperture that will hinder diagnosis and dental treatment. Although there have been reports of patients with diseases and syndromes that cause microstomia, the available literature offers only a limited number of reviews on this topic. The aim of this paper is to present a review of the etiology, clinical characteristics, diagnosis and treatment of microstomia. In addition, to describe the therapeutic adaptations to be applied in dental procedures in patients with microstomia, emphasizing the importance of a preventive approach in this group of patients...

La dificultad en el manejo odontológico es uno de los factores que definen al paciente que requiere cuidados especiales en odontología. Una de las situaciones clínicas que más dificulta el tratamiento dental es la microstomia. La microstomia se define como una apertura bucal pequeña e insuficiente que va a dificultar el diagnóstico y el tratamiento bucodental. Aunque se han descrito casos clínicos de pacientes con enfermedades y síndromes que cursan con microstomia, no hay muchas revisiones del tema en la literatura. El objetivo de este artículo es presentar una revisión sobre la etiología, la clínica, el diagnóstico y el tratamiento de la microstomia. Así como, describir las adaptaciones terapéuticas que se deben aplicar en los procedimientos dentales en el paciente con microstomia, recalcando la importancia de un enfoque preventivo en este grupo de pacientes...

Tratamento de microstomia grave: relato de caso / Treatment of severe microstomia: case report

O tratamento da microstomia é frequentemente um desafio no dia-a-dia do tratamento das sequelas de queimaduras. De maneira geral, as técnicas utilizadas são complexas, com resultados muitas vezes insatisfatórios e com alta taxa de recidiva. O presente trabalho teve como objetivo apresentar um caso grave de microstomia em uma criança de 2 anos, que teve sua resolução alcançada de forma simples, prática e econômica em contrapartida aos métodos tradicionais que muitas vezes são caros, complexos e pouco práticos.

The microstomia treatment is still a challenge in the day by day of the burn sequelae treatment. Usually, the techniques are complex, with poor results and high incidence of recurrence. This study presents a severe case of microstomia in a 2 years old child. The solution was simple, and cheap, in comparison to the traditional surgical methods, usually expensive, complex and low acessibility in a small Center.

Dynamic commissural splint.

Microstomia, an abnormally small oral orifice, can manifest as a sequela of burns involving the oral and perioral tissues due to contraction of the tissues and hypotonia of the circumoral musculature. Regardless of the etiology, scar contracture results in deformities that produce esthetic and functional impairment. Changes in the circumoral anatomy prevent optimal dental care and maintenance of good oral hygiene. The anatomic changes may detrimentally alter eating, speech, and mandibular motion. Prosthetic treatment involves providing physical resistance to scar contracture by maintaining the oral commissures in their normal relationship by means of a splint. This article describes a method to fabricate a dynamic commissural splint and describes its use in two cases.

Systemic sclerosis.

Systemic sclerosis (scleroderma) is a rare generalized disorder of connective tissue origin. This condition is predominantly a clinical diagnosis, based on the clinical signs and symptoms. Here is a case report of 26-year-old female patient with the classical features of this disease. This case is reported for its rarity and variable expressivity. This article also reviews the literature of this uncommon condition.

Manifestaciones orales de la epidermolisis bulosa en el niño / Oral manifestations in children with Epidermolysis Bullosa

La Epidermolisis Bulosa (EB) es un conjunto de enfermedades genéticas que afectan la zona de unión dermo-epidérmica y que presentan lesiones ampollares y erosiones en la piel y mucosas de todo el organismo. Los tejidos blandos y duros de la cavidad oral son afectados con diferente intensidad según la proteína alterada por la enfermedad. El compromiso máxilo-facial conlleva dificultades para la alimentación, higiene y tratamiento odontológico de los pacientes, es por esto que el pediatra, como cabeza de un equipo multidisciplinario que trata a los niños afectados, debe tener presente la importancia de derivar a sus pacientes al odontólogo para que se inicien las medidas preventivas y los tratamientos oportunos y así evitar mayores complicaciones en estos niños. Este trabajo pretende reforzar el conocimiento de las manifestaciones orales de la EB, para que la derivación de los pacientes al odontólogo sea precoz y prioritaria.