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1.
J Prosthet Dent ; 125(1): 138.e1-138.e8, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33393474

RESUMEN

STATEMENT OF PROBLEM: Mini implants (<3 mm in diameter) are being used as an alternative to standard implants for implant-retained mandibular overdentures; however, they may exhibit higher stresses at the crestal level. PURPOSE: The purpose of this finite element analysis study was to evaluate the biomechanical behavior (stress distribution pattern) in the mandibular overdenture, mucosa, bone, and implants when retained with 2 standard implants or 2 mini implants under unilateral or bilateral loading conditions. MATERIAL AND METHODS: A patient with edentulous mandible and his denture was scanned with cone beam computed tomography (CBCT), and a 3D mandibular model was created in the Mimics software program by using the CBCT digital imaging and communications in medicine (DICOM) images. The model was transferred to the 3Matics software program to form a 2-mm-thick mucosal layer and to assemble the denture DICOM file. A 12-mm-long standard implant (Ø3.5 mm) and a mini dental implant (Ø2.5 mm) along with the LOCATOR male attachments (height 4 mm) were designed by using the SOLIDWORKS software program. Two standard or 2 mini implants in the canine region were embedded separately in the 3D assembled model. The base of the mandible was fixed, and vertical compressive loads of 100 N were applied unilaterally and bilaterally in the first molar region. The material properties for acrylic resin (denture), titanium (implants), mucosa (tissue), and bone (mandible) were allocated. Maximum von Mises stress and strain values were obtained and analyzed. RESULTS: Maximum stresses of 9.78 MPa (bilaterally) and 11.98 MPa (unilaterally) were observed in 2 mini implants as compared with 3.12 MPa (bilaterally) and 3.81 MPa (unilaterally) in 2 standard implants. The stress values in the mandible were observed to be almost double the mini implants as compared with the standard implants. The stresses in the denture were in the range of 3.21 MPa and 3.83 MPa and in the mucosa of 0.68 MPa and 0.7 MPa for 2 implants under unilateral and bilateral loading conditions. The strain values shown similar trends with both implant types under bilateral and unilateral loading. CONCLUSIONS: Two mini implants generated an average of 68.15% more stress than standard implants. The 2 standard implant-retained overdenture showed less stress concentration in and around implants than mini implant-retained overdentures.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Análisis de Elementos Finitos , Humanos , Mandíbula/diagnóstico por imagen , Estándares de Referencia , Estrés Mecánico
2.
J Prosthet Dent ; 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33243475

RESUMEN

Implant-supported fixed prostheses in the edentulous maxilla can be difficult because of anatomic limitations and high esthetic demand. The choice between cement and screw retention depends on factors such as esthetics, occlusion, retrievability, and passivity. The choice is also often governed by the ability to manage technical or biologic complications. In the edentulous maxilla, because of the bone trajectory and resorption pattern, unfavorable implant angulations may be encountered. In such situations, a conventional screw-retained prosthesis is difficult to design. This article describes the restoration of edentulous maxillae for a series of patients with different complete-arch fixed prosthesis designs. The clinical guidelines, including indications, advantages, and limitations of each design, were discussed.

3.
J Prosthet Dent ; 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33012529

RESUMEN

STATEMENT OF PROBLEM: Xerostomia refers to the decrease in the quality and quantity of saliva. In denture wearers, xerostomia affects the retention of the denture because of lack of wettability of the denture base. However, which denture base resin materials are best wetted by artificial salivary substitutes is unclear. PURPOSE: The purpose of this in vitro study was to determine the wetting properties of 3 different commercially available denture base resin materials with artificial salivary substitute by using contact angle measurements and to compare these properties before and after thermocycling. MATERIAL AND METHODS: A total 120 specimens were fabricated with 3 different denture base materials (n=40): heat-polymerized polymethylmethacrylate (DenTek), injection-molded nylon polyamide (Valplast), and microwave polymerized (VIPI WAVE). The advancing and receding contact angles were measured with a goniometer by using the WinDrop++ software program. The contact angle hysteresis was calculated from the advancing and receding contact angles values. The same specimens were subjected to thermocycling to measure the advancing and receding contact angles values. The comparative evaluation was carried out before and after thermocycling. RESULTS: The mean ±standard deviation contact angles of the microwave-polymerized material were (62.40 ±1.21 degrees) advancing contact angle, (32.12 ±0.66 degrees) receding contact angle, and (30.28 ±1.40 degrees) contact angle of hysteresis. It was followed by the injection-molded nylon polyamide material, whose mean ±standard deviation contact angle values were (68.57 ±1.72 degrees) advancing contact angle, (43.02 ±1.39 degrees) receding contact angle, (26.27 ±2.05 degrees) contact angle hysteresis and high impact strength heat-polymerized polymethylmethacrylate material, whose mean ±standard deviation contact angle values were (69.81 ±0.16 degrees) advancing contact angle, (41.90 ±1.02 degrees) receding contact angle, and (27.91 ±0.97 degrees) contact angle hysteresis. The statistical analysis showed significant differences among contact angle values of the microwave-polymerized material as compared with the heat-polymerized polymethylmethacrylate and injection-molded nylon polyamide materials (P<.001). CONCLUSIONS: The microwave-polymerized material showed better wettability with artificial saliva substitute than heat-polymerized polymethylmethacrylate and injection-molded nylon polyamide.

6.
Indian J Dent Res ; 31(2): 197-202, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32436897

RESUMEN

Background: The location of the inferior alveolar nerve (IAN) is generally constant in fully grown mandibles. If we know its average distance from the lower border of the mandible, available bone length from the crest of the edentulous ridge can be estimated by physical measurement of the whole length of mandible in that area. This study aimed to measure the superio-inferior distance of the inferior alveolar nerve (SIDIAN) from the base of the mandible in posterior regions on the right and left side based on cone-beam-computed tomography (CBCT) scans and to evaluate gender and ethnicity-related variations in the Malaysian population. Materials and Methods: A total of 100 CBCT-Digital Imaging and Communications in Medicine files of the patients of 3 ethnic populations (Malay, Chinese and Indian) between the ages of 18 and 80 years were selected for the study. The files were imported onto the iCAT software. The measurements of the SIDIAN to the lower border of the mandible in molar regions were done on both sides. The data was analysed using t-test, one-way analysis of variance test, and correlation coefficient test via the SPSS software. Results: Statistically significant positive correlations were identified between the SIDIAN from the lower border of the mandible in the first and second molar regions within the same side as well as between both sides of the mandible (r ≈ 0.8). There were no statistically significant differences between genders. However, there were statistically significant differences on both molar regions and on both sides in all three ethnic groups (P < 0.05). In general, the SIDIAN from the lower border of the mandible was greatest amongst Chinese and smallest amongst Indians. Conclusions: The strong positive correlations on both sides of the mandible indicate the presence of symmetry. Ethnicity-related variations exist in terms of the location of the IAN in the mandible.


Asunto(s)
Implantes Dentales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula , Nervio Mandibular , Persona de Mediana Edad , Diente Molar , Adulto Joven
7.
J Prosthet Dent ; 123(5): 710-716, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31558274

RESUMEN

STATEMENT OF PROBLEM: Single-implant-retained overdentures are an alternative treatment option for an edentulous mandible. However, evaluation of their clinical performance with an immediate loading protocol is lacking. PURPOSE: The purpose of this prospective randomized controlled clinical study was to evaluate crest bone-level changes and patient satisfaction with mandibular overdentures retained by 1 or 2 titanium-zirconium (Ti-Zr) implants with immediate loading protocols after 1 year. MATERIAL AND METHODS: Thirty-six Ti-Zr implants were placed in 24 participants (single central implant in 12 participants and 2 interforaminal implants in 11 participants) by a single operator. LOCATOR attachments were used to retain the mandibular overdentures with an immediate loading protocol, and observations were made at 1 month and 1 year. Changes to the crestal bone level were evaluated with digital periapical radiographs. A 100-mm visual analog scale (VAS) was used to evaluate patient satisfaction. The Mann-Whitney U test was used to analyze the data. RESULTS: At 1 month, the mean crestal bone loss was 0.23 mm in the 2-implant group (n=22) and 0.39 mm (P=.181) in the single-implant group (n=11). At 1 year, the bone loss was 0.67 mm in the 2-implant group and 0.88 mm (P=.248) in the single-implant group. The mean VAS score for patient satisfaction level increased from 38.3% to 49.7% for single-implant participants and from 40.5% to 54.8% for 2-implant participants 1 month after implant placement (P=.250) and from 38.3% to 54.5% for single-implant participants and from 40.5% to 58.9% for 2-implant participants after 1 year (P=.341). CONCLUSIONS: Single-implant-retained mandibular overdentures with an immediate loading protocol may represent a viable treatment option considering crestal bone-level changes and patient satisfaction compared with 2-implant-retained mandibular overdentures after 1 year of follow-up.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Carga Inmediata del Implante Dental , Arcada Edéntula , Estudios de Seguimiento , Humanos , Mandíbula , Satisfacción del Paciente , Estudios Prospectivos
9.
Saudi Dent J ; 31(1): 148-154, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30705578

RESUMEN

Construction of a single complete denture (SCD) is a challenging clinical situation especially when the opposing natural dentition is not in a normal plane of occlusion. Mal-aligned, tilted or supra-erupted teeth in the opposing arch are some of the problems that should be corrected to achieve a balanced occlusion in patients who require SCD. Achieving harmonious occlusal plane is a primary objective of any restorative procedure to facilitate natural mandibular movements and ease of mastication. Establishment of normal occlusal plane in opposite arch is pre-requisite to maintain the stability of the SCD. This clinical report describes restoration of mandibular teeth (with severe attrition and deranged occlusion) by establishing normal plane of occlusion with the help of custom made occlusal plane template (OPT) followed by construction of a complete denture in maxillary arch.

10.
J Prosthet Dent ; 121(3): 517-522, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30391058

RESUMEN

STATEMENT OF PROBLEM: The prosthodontic problems faced by a patient with xerostomia are of great concern. To aid in retention, artificial saliva substitutes should exhibit good wettability on the denture base. PURPOSE: The purpose of this in vitro study was to evaluate the wettability of 3 different artificial saliva substitutes on heat-polymerized acrylic resin and to compare these properties with natural saliva and distilled water. MATERIAL AND METHODS: A total of 150 heat-polymerized acrylic resin specimens were prepared with 25×15×2 mm dimensions. The specimens were divided into 5 groups (n=30): human saliva, distilled water, Aqwet, Mouth Kote, and Stoppers 4. The advancing and receding contact angle values were measured by using a goniometer, and the contact angle hysteresis and equilibrium angle were calculated. One-way ANOVA and the Bonferroni multiple comparisons test were performed to determine the difference between contact angle values among the groups (α=.05). RESULTS: The means of the 5 groups differed significantly (P<.05). The comparison between human saliva and Aqwet showed no significant difference for advancing contact angle, receding contact angle, contact angle hysteresis, or equilibrium contact angle, while comparison between the remaining groups indicated statistically significant (P<.05) results. All 3 saliva substitutes used in this study (Aqwet, Mouth Kote, and Stoppers 4) had significantly better wetting properties than distilled water. CONCLUSIONS: Human saliva had the lowest advancing, receding, and equilibrium contact angle values and the highest angle of hysteresis on heat-polymerized acrylic resin. Aqwet had better wetting ability than the other artificial salivary substitutes tested and was comparable to the human saliva on heat-polymerized acrylic resin. All saliva substitutes have better wetting properties than distilled water.


Asunto(s)
Bases para Dentadura , Calor , Resinas Acrílicas , Humanos , Ensayo de Materiales , Saliva Artificial , Humectabilidad
12.
J Prosthet Dent ; 120(2): 252-256, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29551374

RESUMEN

STATEMENT OF PROBLEM: Buccal corridor space and its variations greatly influence smile attractiveness. Facial types are different for different ethnic populations, and so is smile attractiveness. The subjective perception of smile attractiveness of different populations may vary in regard to different buccal corridor spaces and facial patterns. PURPOSE: The purpose of this study was to determine esthetic perceptions of the Malaysian population regarding the width of buccal corridor spaces and their effect on smile esthetics in individuals with short, normal, and long faces. MATERIAL AND METHODS: The image of a smiling individual with a mesofacial face was modified to create 2 different facial types (brachyfacial and dolicofacial). Each face form was further modified into 5 different buccal corridors (2%, 10%, 15%, 22%, and 28%). The images were submitted to 3 different ethnic groups of evaluators (Chinese, Malay, Indian; 100 each), ranging between 17 and 21 years of age. A visual analog scale (50 mm in length) was used for assessment. The scores given to each image were compared with the Kruskal-Wallis test, and pairwise comparison was performed using the Mann-Whitney U test (α=.05). RESULTS: All 3 groups of evaluators could distinguish gradations of dark spaces in the buccal corridor at 2%, 10%, and 28%. Statistically significant differences were observed among 3 groups of evaluators in esthetic perception when pairwise comparisons were performed. A 15% buccal corridor was found to score esthetically equally within 3 face types by all 3 groups of evaluators. The Indian population was more critical in evaluation than the Chinese or Malay populations. In a pairwise comparison, more significant differences were found between long and short faces and the normal face; the normal face was compared with long and short faces separately. CONCLUSIONS: The width of the buccal corridor space influences smile attractiveness in different facial types. A medium buccal corridor (15%) is the esthetic characteristic preferred by all groups of evaluators in short, normal, and long face types.


Asunto(s)
Estética Dental , Grupos Étnicos , Cara/anatomía & histología , Sonrisa , Adolescente , Adulto , Cara/diagnóstico por imagen , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Fotografía Dental , Estadísticas no Paramétricas , Percepción Visual , Adulto Joven
13.
J Prosthet Dent ; 120(2): 210-213, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29551376

RESUMEN

STATEMENT OF PROBLEM: The inferior alveolar nerve (IAN) frequently loops backward before exiting from the mental foramen and spreads several millimeters medially to the foramen. Implant placement in this area may damage the nerve if the anterior loop area is not carefully identified in a radiographic or computed tomography (CT) evaluation. PURPOSE: The purpose of this observational study was to measure the prevalence of the presence of the anterior loop and to estimate sex and ethnicity-related variations in anterior loop length in the Malaysian population. MATERIAL AND METHODS: A total of 100 cone beam computed tomography (CBCT) Digital Imaging and Communications in Medicine (DICOM) files were selected from a pool of 810 ongoing or completed patients in 3 different ethnic groups: Malay (33), Indian (33), and Chinese (34). The DICOM data were imported into commercial software. The IAN was traced with software along with the anterior loop and part of the incisive nerve. The vertical length of the nerve was estimated from the canal to the opening of the mental foramen from the cross-sectional view and translated to the panoramic view. Measurement was made from this point to the most anterior point of the anterior loop by following the trajectory of the nerve and was repeated on the opposite side. A 2-way mixed analysis of variance (ANOVA) test was carried out to evaluate the sex- and ethnicity-related variations (α=.05). RESULTS: The anterior loop was present in 94% of the 100 participants. Overall anterior loop length (AnLL) ranged between 0.73 and 7.99 mm with a mean length of 3.69 ±1.75 mm on the left side and 3.85 ±1.73 mm on the right side. Among all participants, no statistically significant differences were found between the left and right sides of the mandible (P=.379). Overall, no significant main effect of ethnicity (P=.869) or sex (P=.576) was found on AnLL measurements. Also, with multiple comparisons, no significant effect was found between each pair of ethnic groups. Men in all 3 ethnic groups had greater AnLL than women. CONCLUSIONS: The anterior loop was present in 94% of the 100 participants among the 3 major ethnic groups of Malaysia. Overall AnLL ranged between 0.73 and 7.99 mm and mean lengths of 3.69 ±1.75 mm on the left side and 3.85 ±1.73 mm on the right side, with no significant ethnicity- or sex-related variations.


Asunto(s)
Implantación Dental Endoósea , Grupos Étnicos , Mandíbula/anatomía & histología , Nervio Mandibular/anatomía & histología , Factores Sexuales , Análisis de Varianza , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Malasia , Masculino , Mandíbula/diagnóstico por imagen , Nervio Mandibular/diagnóstico por imagen , Programas Informáticos
14.
J Prosthet Dent ; 119(4): 568-573, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28838820

RESUMEN

STATEMENT OF PROBLEM: The genial tubercle is a clinically palpable landmark in the mandible and can be identified in cone beam computed tomography (CBCT). Its location can be used to measure the safe zone in the interforaminal region of the mandible. These measurements may be helpful for implant treatment planning in patients with complete edentulism. PURPOSE: The purpose of this clinical study was to evaluate the safe distance in the interforaminal region of the mandible measured from the genial tubercle level for implant osteotomy in a Chinese-Malaysian population. MATERIAL AND METHODS: A total of 201 Digital Imaging and Communications in Medicine (DICOM) files were selected for the study from the CBCTs of dentate or edentulous Chinese-Malaysian adult patients with ongoing or completed treatments. Measurements were made with implant planning software. The anatomy of the whole mandible was assessed in the coronal cross-sectional, horizontal view and in panoramic view. Measurements were obtained in millimeters on one side by locating and marking a genial tubercle and then marking the mesial margin of the mental foramen and the anterior loop of the inferior alveolar nerve. The corresponding points of these landmarks were identified on the crest of the mandibular ridge to measure the linear distances. All the measurement steps were repeated on the other side. The linear distance of 2 mm was deducted from the total distance between the genial tubercle and the anterior loop separately for left and right side measurements to identify the safe zone. The mixed 2-way analysis of variance (ANOVA) test was used to analyze side and sex-related variations. RESULTS: The mean safe zone measured at the crestal level from the genial tubercle site on the left side of the mandible was 21.12 mm and 21.67 mm on the right side. A statistically significant (P<.05) difference was found between the left and right sides of the safe zone measurements in both men and women. No statistically significant differences were found in the safe zone between men and women on either the left or right side (P=.655). The minimum distance from the genial tubercle to the right side safe zone in women was 12.82 mm and 14.99 mm in men; however, on the left side, the minimum distance was observed to be 14.81 mm in women and 15.54 mm in men. CONCLUSIONS: The safe zone related to the genial tubercle was 21.12 mm on the left side and 21.67 mm on the right side, with no significant sex-related variations. Within the same individuals, a significant difference was found in the safe zone between the left and right side.


Asunto(s)
Puntos Anatómicos de Referencia , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Asiática , Traumatismos del Nervio Craneal/prevención & control , Femenino , Humanos , Arcada Edéntula/cirugía , Malasia , Masculino , Mandíbula/anatomía & histología , Nervio Mandibular , Persona de Mediana Edad , Osteotomía , Adulto Joven
15.
J Prosthodont ; 27(3): 314-316, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27333596

RESUMEN

Accurate planning for the framework design of removable partial dentures requires careful analysis of the diagnostic cast with a dental surveyor to determine the optimal path of placement. Some techniques described in the literature are helpful in reorienting the same cast on the surveyor, including the tripod marking method; however, there is a possibility of introducing human errors during marking and repositioning of the tripod points on to the different casts at the same location. Other techniques, which do not require markings on the cast to reorient different casts of the same patient, need specific devices or trays. This article suggests the direct use of a putty-elastomeric orientation index that can be preserved and used multiple times while reorienting different casts of the same patients at various laboratory steps. A putty elastomeric impression material is mixed and adapted on to the diagnostic cast, covering key teeth areas of the cast and incorporating the analyzing rod of the surveyor. Thus there is no need to use a special device or the tray to reorient different casts.


Asunto(s)
Técnica de Colado Dental , Dentadura Parcial Removible , Humanos
16.
J Prosthodont ; 27(1): 94-97, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27002917

RESUMEN

Bilateral cleft lip/cleft palate is associated with nasal deformities typified by a short columella. The presurgical nasoalveolar molding (NAM) therapy approach includes reduction of the size of the intraoral alveolar cleft as well as positioning of the surrounding deformed soft tissues and cartilages. In a bilateral cleft patient, NAM, along with columellar elongation, eliminates the need for columellar lengthening surgery. Thus the frequent surgical intervention to achieve the desired esthetic results can be avoided. This article proposes a modified activation technique of the nasal stent for a NAM appliance for columellar lengthening in bilateral cleft lip/palate patients. The design highlights relining of the columellar portion of the nasal stent and the wire-bending of the nasal stent to achieve desirable results within the limited span of plasticity of the nasal cartilages. With this technique the vertical taping of the premaxilla to the oral plate can be avoided.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Stents , Expansión de Tejido/instrumentación , Proceso Alveolar/anomalías , Proceso Alveolar/crecimiento & desarrollo , Humanos , Lactante , Nariz/anomalías , Nariz/crecimiento & desarrollo
18.
J Indian Prosthodont Soc ; 17(1): 84-88, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28216851

RESUMEN

INTRODUCTION: Maxillary obturator prosthesis is more frequent treatment modality than surgical reconstruction for maxillectomy in patients suffering from oral cancer. The obturators often become heavy and hence are hollowed out in the defect portion to reduce its weight as a standard practice. MATERIALS AND METHODS: The processing technique described the incorporation of the preshaped "wax-bolus" during packing procedure of the Obturtor prosthesis and eliminated later by melting it once the curing procedure is completed. RESULTS: This article is a single step procedure resulting into the closed-hollow obturator as single unit with uniform wall thickness around the hollow space ensuring the least possible weight of the hollow obturator. CONCLUSION: This processing technique achieves predictable internal dimension of the hollow space providing uniform wall thickness of the obturator.

19.
J Prosthodont ; 26(5): 481-482, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26683255

RESUMEN

Various tools are used with a dental surveyor, including analyzing rods, carbon markers, undercut gauges, and protective sheaths for a specific function. A carbon marker is a parallel-sided carbon rod used to mark the survey line on a cast or a crown on a cast. The carbon marker (with or without protective sheath) cannot differentiate more than one survey line on the cast if needed. The wear of the carbon marker along the parallel walls after repeated use may give an incorrect survey line. We suggest a simple modification in the analyzing rod to prepare a two-colored surveying tool. An analyzing rod is a parallel-sided rod used to analyze the relative parallelism of two or more surfaces of a cast and to mark survey lines on wax patterns. With the modified analyzing rod, the survey lines can be marked with two colors, and the problem of breaking of the carbon marker also can be eliminated.


Asunto(s)
Técnica de Colado Dental/instrumentación , Carbono , Color , Diseño de Prótesis Dental/instrumentación , Diseño de Prótesis Dental/métodos , Humanos
20.
Case Rep Dent ; 2016: 4618510, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27843652

RESUMEN

Patient. A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture. This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant. Discussion. Severe limitation in the oral opening may occur in clinical situations following the postsurgical management of oral and maxillofacial defects. The prosthetic rehabilitation of the surgical defect in such patients becomes a challenging task due to limited access to the oral cavity. This challenge becomes even more difficult if the patient is edentulous and there are no teeth to gain the retention, stability, and support. Conclusion. In severe microstomia prosthesis insertion and removal can be achieved with modification of the maximum width of the prosthesis. Dental implant retention is useful treatment option in edentulous patients with maxillary surgical defect provided that sufficient bone volume and accessibility are there for implant placement.

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