RESUMO
Background: As a newer modality of rehabilitation of completely edentulous patients, there is no conclusive evidence on which of the variants of hybrid prosthesis, namely acrylic teeth on a metal substructure or porcelain fused to metal teeth over on a metal substructure, is better in terms of treatment outcome, reduced mechanical complications, and better patient compliance. Methods: Sixteen completely edentulous patients, both male and female, were selected from the OPD of the study centers during the study period. Group A: Eight patients rehabilitated by maxillary and mandibular hybrid prosthesis using a substructure of metal covered by acrylic teeth, which was screwed on the implants. Group B: Eight patients rehabilitated by maxillary and mandibular hybrid prosthesis using a substructure of metal covered by porcelain fused to metal teeth, which was screwed on implants. The patients were recalled at 3 months, 6 months, and 1 year following rehabilitation, and necessary clinical and radiological observations were made to evaluate the overall health and complications. Oral health-related quality of life was measured using the Oral Health Impact Profile (OHIP)-EDENT questionnaire before treatment and after rehabilitation. The same methodology, clinical procedures, and evaluation criteria were followed in all the study centers. The data obtained were then compiled and analyzed. Results: None of the patients in group A or B showed any signs of need to remake. There was no statistically significant difference in proportions of cases showing signs of loosening of components, soft tissue overgrowth, breakage of acrylic, chipping of porcelain, and wear of teeth in both the groups. The amount of screw loosening, wear of prosthetic superstructure, and bone loss around implants were less (even though not statistically significant) in group A. Both the groups showed satisfactory esthetics. OHIP- EDENT evaluation gave completely satisfactory report after rehabilitation in both groups. Conclusion: Both the types of complete rehabilitation, hybrid prosthesis of acrylic teeth on a metal substructure and hybrid prosthesis of porcelain fused to metal teeth on a metal substructure were successful and comparably reliable.
RESUMO
Maxillofacial defects can result from trauma, treatment of neoplasm, or congenital malformations. Many a time due to the size, location of the defect, or because of the patient's medical condition, surgical reconstruction may not be possible. In these cases, rehabilitation is indicated with the help of a maxillofacial prosthesis. Orofacial digital syndrome (OFDS) is a congenital anomaly that affects the development of the mouth, face, and digits. Such abnormalities or defects compromise form, function, esthetics, and social acceptance and deeply affect the psychological status of an individual. This report describes the comprehensive prosthetic rehabilitation of a case of OFDS with bilateral cleft lip and palate as well as syndactyly and brachydactyly of the foot. The individual was rehabilitated with a definitive obturator and a custom-made foot prosthesis using room-temperature-vulcanizing silicone. The prosthetic rehabilitation significantly improved esthetics, phonetics, and function as well as social and psychological status of the patient.
