A Modified Technique for Fabrication of Magnetic Retained Cheek Plumper in Completely Edentulous Patient with Sunken Cheeks – A Case Report

Abstract

Current concept of complete denture rehabilitation is more concentrated on the harmonization between the artificial and natural tissues. In certain cases with sunken cheeks, patients need extra support to the dentures. Sunken cheeks are best restored using cheek plumper or cheek lifting appliances. Conventional cheek plumper appliances have issues such as increased weight, hampering the denture retention and muscle fatigue in patients. So, to overcome all these difficulties, literature reported various modifications in fabrication and designing of a cheek plumper prosthesis. The present case report describes the outcomes of a modified check plumper appliance in a completely edentulous patient with sunken cheeks. Cheeks play a crucial role in facial aesthetics due to their extreme visibility.1 the form of the cheeks is determined by the teeth, ridges and contour of the dentures, especially when restoring a completely edentulous patient. During the due course of life, patients experience concaving and hollowing of the cheeks due to extraction of posterior teeth, thinning of tissues due to ageing or weight loss.1 Prosthodontic rehabilitation should not only aim at restoring and replacing the missing teeth, but also restore the facial support. Conventional procedures fulfill the requirements in most of the cases. But, in cases with sunken cheeks, patients need extra support to the dentures. Sunken cheeks are best restored using cheek plumper or cheek lifting appliances. Use of cheek plumper prosthesis in maxillofacial prosthodontics is well documented in the previous literature.2, 3, and 4 Usually denture flanges provide support to the perioral musculature but they fail to mimic the fullness of the cheeks. So, cheek plumper helps in providing a necessary support to the cheeks and thereby enhancing the aesthetics. Usually, cheek plumpers can be un-detachable or conventional type and detachable cheek plumpers. 5 A conventional one is single unit prosthesis with a supporting extension near premolar or molar region. The major disadvantages with un-detachable cheek plumpers are increased weight hampering the retention, difficulty during denture insertion, muscle fatigue and cannot be used in patients with limited mouth opening.6 To overcome the above mentioned problems, the cheek plumper used in the present case was innovated in two aspects. One was the usage of magnet retained attachments for the flanges and the other was to decrease the overall weight of the denture by hollowing the cheek plumper, increasing the retention. The present case report is innovative as compared to the previous literature. None of the case reports have used the hollowing technique for plumpers which attributes to additional decrease in the weight of the denture. The present case report highlights the outcome of a modified check plumper appliance in a completely edentulous patient with sunken cheeks.