Prosthetic rehabilitation with collapsible hybrid acrylic resin and permanent silicone soft liner complete denture of a patient with scleroderma-induced microstomia.

Scleroderma is an autoimmune multisystem rheumatic condition characterized by fibrosis of connective tissues of the body, resulting in hardening and impairment of the function of different organs. Deposition of collagen fibers in peri-oral tissues causes loss of elasticity and increased tissue stiffness, resulting in restricted mouth opening. A maximal oral opening smaller than the size of a complete denture can make prosthetic treatment challenging. Patients with microstomia who must wear removable dental prostheses (RDPs) often face the difficulty of being unable to insert or remove a conventional RDP. A sectional-collapsible denture is indicated for the prosthetic management of these patients, but reduced manual dexterity often makes intraoral manipulation of the prosthesis difficult. A single collapsible complete denture is a better choice for functional rehabilitation of these patients. This clinical report describes in detail the prosthodontic management of a maxillary edentulous patient with restricted mouth opening induced by scleroderma with a single collapsible removable complete denture fabricated with heat-polymerized silicone soft liner and heat-cured acrylic resin. The preliminary and secondary impressions were made with moldable aluminum trays by using putty and light-body poly(vinyl siloxane) elastomeric impression material. The collapsed denture can be easily inserted and removed by the patient and also provides adequate function in the mouth.

Hader bar and clip attachment retained mandibular complete denture.

Bar and clip attachments significantly improve the level of satisfaction of denture-wearing patients by enhancing the retention and stability of the prosthesis. These attachments have been most commonly used for connecting the prosthesis to implants, but they can be effectively used to retain tooth-supported prosthesis as well. The primary functions of bar attachments are splinting the abutments together, even distribution of forces to the abutments and supporting areas, guiding the prosthesis into place, improving the retention, stability, support and comfort of the patient. The primary requirement for the use of bar attachments is the availability of sufficient vertical and buccolingual space for the proper placement of the bar, sleeves, teeth arrangement and sufficient thickness of acrylic denture base to minimise incidence of denture fracture in the area of bar assembly.

Early dental implant failure in patient associated with oral bisphosphonates.

Oral bisphosphonates are routinely prescribed to post menopausal women. These have shown to increase the risk of osteonecrosis. However, this action may be augmented by local factors. A case report is presented showing an early implant failure in a patient taking oral bisphosphonates. Two implants were placed in left maxillary incisor area. Central incisor was associated with a previous endodontic failure and extraction. Lateral incisor was avulsed 3 years back. After 4 weeks of an implant placement, necrotic bone was evident along with the failing implant in central incisor area. This case report emphasizes on the incidence and an increased risk of implant failure in patients taking oral bisphosphonates.