Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report

Abstract

Patients with Down syndrome can present with a variety of oral manifestations such as hypodontia, periodontal disease, premature tooth loss, reduced salivary flow, crowding of teeth in both arches, and decreased occlusal vertical dimension. The intellectual ability of people with Down syndrome varies widely. They present with a mild-to-moderate intellectual disability that restricts their ability to communicate and adjust to their environment, which can add complexity in the overall dental treatment. There is little information in the literature regarding the prosthodontic rehabilitation for patients with Down syndrome in combination with dental implant placement. An implant-assisted removable partial dental prosthesis can be a cost-effective treatment alternative for carefully chosen patients with Down syndrome. This article presents the treatment of a 44-year-old male patient with Down syndrome and a moderate intellectual disability who presented with congenital and acquired tooth loss with significant occlusal discrepancies. The treatment included a prosthodontic approach that used a single dental implant, which will be described and illustrated in this article.

Dental aspects of children with Down syndrome

“…Before starting of the implementation of the orthodontic treatment within the patients with Down syndrome, it is necessary to restore all decay teeth. If the patient is unable for clinical work, orthodontic treatment can be initiated with a mobile device [22], which usually carried extension of the upper jaw and, if necessary, '' pull '' of the front teeth due to the presence of the pseudoprogenia [23]. Treatment can be continued with a fi xed appliance that compensates dental chains, regulates the placement of the teeth in the dental chains and adjust dental bite [24].…”

Determination of mandibular morphology in a TURKISH population with Down syndrome using panoramic radiography

“…In addition, some studies have reported the social status of DS individuals [26]. Also, although implant applications in patients with DS are usually performed under general anesthesia [8], local anesthesia procedures have also been reported [9, 10]. When the increase in average life span and social adaptation are considered, it is indicative that there will be a patient profile of DS individuals who will attend clinics in the coming years, and this has increased even more than the expectation of complicated treatment has in the past.…”

“…Although implant applications in patients with DS are usually performed under general anesthesia [8], local anesthesia procedures have also been reported in recent years [9, 10]. The vertical bone level on the mandible and the mandibular canal anatomy, including variations thereof, should be well known in patients with DS who will undergo a mandibular implant.…”

Prosthodontic Rehabilitation of an Ectodermal Dysplasia Patient with Implant Telescopic Crown Attachments

“…Moreover, implant TCA provides more horizontal stability to the RDP against lateral dislodgment forces compared to other solitary implant attachments . In contrast to Locator and ball attachments, implant TCA requires more restorative space and is time‐consuming; however, excessively angulated implants accelerate wear of the nylon insert of these attachments and lead to more frequent replacement . Therefore, TCAs can be milled at a different angle to overcome the different implant angulations, which will ease placement of the overdenture prosthesis and reduce the risk of attachment wear.…”