Prosthodontics for pediatric patients with congenital/developmental orofacial anomalies: a long-term follow-up.

Patients afflicted with congenital/developmental anomalies of the oral/head and neck regions present the prosthodontist with unique esthetic and functional restorative challenges. This article reviews the various pediatric patient categories that would benefit from placement of "vital" overdentures. A long-term follow-up of patients seen over 25 years of practice is presented with a focus on complications such as temporomandibular joint stability, caries, soft tissue and bony support changes, and denture adaptation. Longitudinal follow-up of these patients indicates that, although problems occur with overdenture therapy, the benefits of this treatment far outweigh the complications.

Prosthetic treatments for patients with ectodermal dysplasia.

This article defines and describes the nature of ectodermal dysplasias, highlighting the dental complications associated with this congenital/developmental condition. A treatment protocol for meeting patients' functional and esthetic needs as they grow into adulthood is presented.

Use of a cross-mounting buccal index to help transfer the spatial relationships of an interim prosthesis to the definitive implant-supported prosthesis.

This article describes a new method for the fabrication of an index for definitive implant abutment selection, framework design, and fabrication. After the interim removable restoration is esthetically and functionally accepted by the patient and dentist, it can be used as a surgical guide during implant placement as well as a guide for abutment selection, framework design, and fabrication. The concepts used in the fabrication of the cross-mounting buccal index include having a reference point, maintaining the vertical dimension of occlusion, and supplying the ability for cross mounting. This procedure allows the clinician to use a duplicate of the interim restoration to select the abutments and fabricate the framework without a new denture setup. It also accelerates both patient chairtime and laboratory time, and it enhances the prosthodontic outcome.

Prosthodontic consideration in the treatment of patients with maxillary and mandibular deficiencies.

Despite advancements in surgical osteotomy repositioning procedures for congenital and developmental intermaxillary deficiencies, prosthetic rehabilitation remains a viable alternative in some patients. In developing a treatment plan, the advantages and disadvantages of both surgical and prosthetic rehabilitation must be weighed. The interdisciplinary team approach is best for treatment planning. The treatment options are presented with a variety of treatment philosophies. Maxillofacial surgical and/or prosthetic treatments must be carefully coordinated to ensure the best results for patients with moderate to severe "jaw" discrepancies.

Evaluation of mandibular movements in the horizontal plane made by partial mandibulectomy patients--a pilot study.

The purpose of this pilot study of the partial mandibulectomy patient was to make ttracings of their mandibular movement in a horizontal plane of orientation in the hope that the results would provide information regarding the prosthetic rehabilitation of these patients. The anterior part of a pantograph recording unit was used in making the tracings. The results of the study indicate that racings on partial mandibulectomy patients are diagnostic in nature regardless of the range and extent of movement seen. As has been stated by other authors who have studied this type of patient, more clinical research should be undertaken before a full understanding of the ramifications of prosthetic rehabilitation of the partial mandibulectomy patient can be realized.

Dentures as artificial saliva reservoirs in the irradiated edentulous cancer patient with xerostomia: a pilot study.

Dentures which included a reservoir for dispensing artificial saliva were constructed for a trial group of patients with oropharyngeal cancer seen in the postirradiation period. The tumors were apparently under control, but the patients were suffering from xerostomia. Details of the design, construction, and use of such a device are presented. The subject of postirradiation xerostomia in the edentulous patients is reviewed, and recommendations for reducing the incidence and severity of this condition are given. The prosthesis contributed to successful oral rehabilitation of half the trial group of patients with postirradiation xerostomia.

Maximizing support for maxillary defects.

The use of the medical-grade silicone obturator can aid the prosthodontist attempting prosthetic closure of maxillary defects. This type of obturator prosthesis allows the patient to resume near-normal oral function. It aids in the preservation of the oral structures because it uses the support available from the defect to reduce the force per unit area on the remaining "normal" oral structures.