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This article describes a preliminary impression technique for edentulous patients with microstomia. Stock impression trays are modified to make sectional impressions of the left and right sides of the maxillary arch. The cast poured into the first impression is positioned in the second impression, which is then poured to make the diagnostic cast.
Regardless of cause, the treatment of an edentulous patient with microstomia is difficult and often ingenious. Prosthodontic treatment modalities previously described are reviewed. A new type of prosthesis, the collapsible mandibular swing-lock complete denture, is introduced. The prosthesis incorporates a cast cobalt-chromium framework with a lingual hinge and a conventional labial swing-lock. This combination allows the prosthesis to be collapsible while maintaining structural durability. Advantages include ease of insertion and removal while providing maximum coverage for support, retention, and stability. A stepwise technique for the clinical and laboratory phases is described.
Treatment of severe microstomia caused by swallowing of caustic soda is presented. The oral cavity was severely constricted because of mucosal adhesions. We used a free forearm flap for reconstruction of the oral cavity and vermilion flaps at the oral commissure, with satisfactory results. A technique is presented, and the problems with respect to the reconstruction of the oral cavity are discussed.
Expanding oral angle plasty using a subcutaneous pedicle flap to correct severe microstomia due to extensive facial scar contractures is described. This technique is especially suited for the elderly, who are unable to tolerate large skin grafting of the face, and for patients with insufficient normal donor skin to undertake extensive correction of scar contractures.
Microstomia may be a disfiguring complication of severe burn injuries of the soft tissues of the face. The constriction of the perioral myocutaneous tissues following such trauma poses several problems and usually necessitates major plastic and reconstructive intervention. A novel technique is described which limited the anticipated constriction of perioral tissues in a 21-year-old female who suffered full skin thickness burns to 65 per cent of her body, including her face, following a self-induced petrol burn.
This clinical report illustrates how an active traction appliance was made for a patient with severe microstomia by attaching custom-made lip retractors to an orthodontic headgear. A steady, light tensile force was imparted to the lips with the elastic bands between the retractors and the headgear.
Severe limitation in the oral opening, though an uncommon clinical presentation, makes gaining access to the oral cavity difficult for any dental procedure. This article describes the maxillofacial prosthetic management of a patient with a midfacial defect complicated by postsurgical microstomia. Intraoral and extraoral prostheses restored the patient's speech, dental articulation, mastication, lip support, esthetics, and anterior oral seal.
This clinical report describes the fabrication of a sectioned mandibular complete denture for a patient with severe microstomia. Dovetails were created in the denture base to orient and secure the prosthesis.
One of the complications of thermal injury is the development of scars and contractures during the healing process. This scarring can be devastating, especially when it involves the mouth. The purpose of this report is to describe the construction of an alternative vertical mouth stretching orthosis for vertical microstomia. By using thermoplastic splinting material and a long thread screw, a vertical mouth-stretching orthosis can be custom-fit to any patient's mouth. The device can be fabricated for a pediatric or adult patient for the rehabilitation of a circumferential mouth burn, especially targeting the vertical diameter. When using this device, patients gave positive feedback for comfort and ease of use, with increased mouth mobility and range of motion. This vertical orthotic device provides an economical and comfortable alternative for vertical mouth diameter enlargement to the current five devices available in the literature.
PATIENT: The patient was a 48-year-old partially edentulous male with microstomia. His chief complaints were masticatory disturbance and aesthetic problems caused by missing teeth. After trayless impressions for diagnostic casts were made, sectional trays and a sectional record block were used for the definitive impression and maxillomandibular registration. Maxillary and mandibular acrylic sectional dentures were simultaneously delivered. DISCUSSION: Low caries activity, minimal occlusal force, appropriate plaque control, and simple designs for connecting portions of the two halves of the sectional dentures might lead to satisfactory results in this case. CONCLUSION: No problems have been observed for approximately 6 years after delivery of the acrylic sectional dentures for this microstomic patient.
A case of microstomia caused by swallowing caustic soda is presented. A 54-year old man developed a progressive stricture of the circumoral region following accidental ingestion of caustic soda when he was 9 years old. He was treated by a general surgeon who performed bilateral commissurotomies when he was 19 years old and lived normally until he needed major dental prosthetic treatment. His dentist was unable to perform the treatment due to the mouth stricture. The surgical option was to perform bilateral buccal mucosal flaps. A review of the literature and the surgical technique are presented.
This paper provides an overview of the dental management of patients with microstomia. A brief review of its etiology is presented, along with advice on planning preventive and operative care.
The authors describe a case of plurimalformative syndrome, characterized by agnathia, microstomia, synotia and by cardiac and pulmonary maldevelopment. The case peculiarity consist in the rarity of this malformative occurrence; moreover, the authors underline the occurrence of familiarity with Seckel's Syndrome.
A rare case of the in utero observation of agnathia, microstomia, and synotia associated with hydramnios is presented. The correct diagnosis is made by observing an absent mandible in a patient with hydraminios.
Two patients with microstomia in the absence of any features of progressive systemic sclerosis are documented. Follow-up of almost 20 years did not reveal development of any features of this disease. The first patient had systemic lupus erythematosus and the second rheumatoid arthritis/Sjögren's syndrome with a complicating myositis.
Perioral burns may occur due to electrical, thermal, or chemical agents. The resultant contracture of the facial tissue during healing causes limited oral access, compromised esthetics, and other related problems. This article presents various microstomia prevention appliances used by dentists and hospital burn centers. These appliances reflect different treatment concerns, ease of fabrication, age appropriateness, and cost effectiveness. An understanding of these factors and available appliances will aid the clinician in selecting or developing the best appliance for burn patients.
Patients who have sustained a facial burn often contend with cosmetic and functional challenges, including microstomia. Many devices have been created by a variety of professionals to provide oral stretching. These devices can be classified as intraoral or extraoral and deliver a stretch either horizontally, vertically, or circumorally. The purpose of this article is to present a comprehensive review of oral-stretching devices.
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