Rehabilitation of Facial Palsy Patient with Implant Supported Lower Overdentures: Case Report
Keywords:
prosthodontic management, facial palsy, implantsAbstract
Using complete dentures of patients with facial palsy always has some problems, due to poor neuromuscular control movements of mandibles those interfere denture retention, stability, and their denture aesthetic.
Case study: A 81- year-old man has had facial muscle weakness for 7 years, and was diagnosed as left facial nerve palsy with hearing loss due to malignant otitis externa with osteomastoiditis. He was treated by medication, and surgical correction for lagophthalmos. The patient would like to have a complete dentures. Extraoral examination revealed facial asymmetry and falling of left corner of the mouth with salivary drooling. The mandible slightly deviated to the right. Pronunciation were not clear at bilabial and labiodental articulation. The patient could not move the mandible and bite following doctor order, and occlusion was unstable. Preliminary impressions were performed with alginate impression material and final impression with border molding was done by using silicone impression material. Occlusal rim was tried in and anterior maxillary plane was set. Evaluation of occlusal vertical dimension was difficult due to poor control of mandibular movement and nonrepetitiveness. Therefore, doctor had to support and guide the mandible during determining interarch relationship. Artificial teeth were arranged upon lingualize’s theory and the buccal flange of left upper dentures were expanded to support the left cheek. Occlusion wax was changed to permanent prosthesis after the patient satisfied with esthetic, pronunciation, and biting. Surgical placement of osteo-integrate implants was done. Lower dentures should not be used at least 2 weeks. Four months later, locators were attached to dental implants. The patient was scheduled for dental check- up after 2 weeks for evaluating the dentures, implants, and oral hygiene care. Follow-up for 1 and 3 months after denture delivery, the patient was satisfied with quality of chewing, esthetic, and denture retention. Conclusion, this case report presents the rehabilitation of a facial palsy patient with implants supported lower over dentures. That prosthesis improves patient’s sense of well-being.
References
Adell R, Eriksson B, Lekholm U, et al. Long term follow up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5(4):347–59.
Lenkholm U, Steenberhe DV, Herrmann I. Osseointegrated implants in the treatment of partially edentulous jaws: A prospective 5 year multicenter study. Int Oral Maxillofac Implants 1994;9(6):627–35.
Romero-Pérez MJ, Mang-de la Rosa MdR, López-Jimenez J, et al. Implants in disabled patients: a review and update. Med Oral Patol Oral Cir Bucal 2014;19(5):e478–82.
Muthuvignesh J, Kumar NS, Reddy DN, et al. Rehabilitation of Bell’s palsy patient with complete dentures. J Pharm Bioallied Sci. 2015;7(Suppl 2):S776–8.
Rajapur A, Mitra N, Prakash VJ, et al. Prosthodontic Rehabilitation of Patients with Bell’s Palsy: Our Experience. J Int Oral Health. 2015;7(Suppl 2):77–81.
Godavarthi SS, Sajjan S, Raju R, et al. Extended buccal flange technique to manage bells palsy patient with complete denture. International Journal of dental clinic. 2012;6:58-60
Kaur S, Suman N, Singh K, et al. Concept In Management Of Edentulous Bell’s Palsy Patient-A Case Report. Indian Journal of Dental Sciences. 2014;6:60–1
Lazzari JB. Intraoral splint for support of lips in Bells palsy. J Prosthet Dent. 1955;5: 579–81.
Larsen SJ, Carter JF, Abrahamian HA. Prosthetic support for unilateral facial paralysis. J Prosthet Dent 1976;35:192–201.
Carlsson GE. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws. J Adv Prosthodont 2014; 6(4):245–52.
Chee W, Jivraj S. Treatment planning of the edentulous mandible. Br Dent J 2006; 201(6):337–47.
Chee GH, Nedzeski JN. Facial nerve grading systems Facial Plast Surg 2000;16(4):315–24.
Heckmann SM, Heckmann JG, Weber HP. Clinical outcomes of three Parkinson´s disease patients treated with mandibular implant overdentures. Clin Oral Implants Res 2000;11(6):566–71.
Véron C, Chanavaz M, Ferri J, et al. A panorama of current materials for osseous application in maxillofacial surgery and oral implantology. Revue de stomatologie et de chirurgie maxillo-faciale. 1995;96(4):274–81.
Bishara SE. Textbook of Orthodontics. New York: W.B.Saunders company; 2001.
Robert G, Anderson MD. Facial nerve disorders and surgery. Sel Read Plast Surg 2006;10:1–41.
Malik NA. Facial nerve and motor disturbances of the face and jaws In: Malik NA, editor. Text Book of Oral and Maxillofacial Surgery New Delhi: Jaypee Brothers Medical Publishers 2008. p. 719–21.
Slavkin HC. The significance of a human smile: Observations on Bell’s palsy J Am Dent Assoc 1999;130(2):269–72
Inada M, Yamazaki T, Shinozuka O, et al. Complete denture treatments for a cerebral palsy patient by using a treatment denture. A case report J Med Dent Sci 2002;49(2):171–7.
Becker CM, Swoop CC, Guckes AD. Lingualized occlusion for removable prosthodontics J Prosthet Dent 1977;38(6):601–8.
Mericske-Stern RD, Taylor TD, Belser U. Management of the edentulous patient. Clin Oral Implants Res 2000;11:108–25.
Meijer HJ, Raghoebar GM, Van ‘t Hof MA. Comparison of implant‐retained mandibular overdentures and conventional complete dentures: a 10‐year prospective study of clinical aspects and patient satisfaction. Int J Oral Maxillofac Implants. 2003;18(6):879–85.
Meijer HJ, Raghoebar GM, Batenburg RH, et al. Mandibular overdentures supported by two or four endosseous implants: a 10‐year clinical trial. Clin Oral Implants Res. 2009;20(7):722–8.
Cune M, Burgers M, Kampen Fv, et al. Mandibular overdentures retained by two implants: 10‐year results from a crossover clinical trial comparing ball‐socket and bar‐clip attachments. Int J Prosthodont. 2010;23(4):310–7.
Siddharth B, Meena AA, Vidya C. Guidelines for treatment planning of mandibular implant overdenture. Journal of Dental Implant. 2014;4:86–90.
Patel PB. Narrow-diameter implants: A minimally invasive solution for overdenture treatment - part 2. Aust Dent Pract. 2013;24(2):180–186.
Omura AJ, Latthe V, Marin MM, et al. Implant-assisted removable partial dentures: practical considerations. Gen Dent 2016;64(6):38–45.
Smith RA, Berger R, Dodson TB. Risk factors associated with dental implants in healthy and medically compromised patients. Int J Oral Maxillofac Implants 1992;7(3):367–72.
Rogers JO. Implant-stabilized complete mandibular denture for a patient with cerebralpalsy. Dent Update 1995;22(1):23–6.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
