Sectional Impression Tray and Sectional Denture for a Microstomia Patient

Abstract

Microstomia presents a unique challenge to the patient. Patients with microstomia who must wear removable dental prostheses often face the difficulty of being unable to insert or remove the prosthesis because of the constricted opening of the oral cavity. A completely edentulous patient, who developed microstomia along with Raynaud's phenomenon induced by scleroderma, is presented. This clinical report describes a quick and easy method for fabrication of a sectional custom impression tray connected by press button and a sectional complete denture retained by magnets. A sectional denture that provides ease in placement and removal can be successfully used in clinical practice for treatment of microstomia patients.

Fabrication of Customized Sectional Impression Trays in Management of Patients with Limited Mouth Opening: A Simple and Unique Approach

“…Many techniques were described in the literature for impression making in dentulous and edentulous patients with limited mouth opening. Various mechanisms like hinges [4], locking levers [5], plastic blocks [6, 7], orthodontic expansion screws [8], magnet systems [9], parallel pins [10], and so forth were used so far for fabricating sectional trays. In the present case reports, incorporation of complicated locking devices was avoided by designing a locking mechanism within the tray handle to secure the tray segments three dimensionally.…”

A Simplified Clinical Technique for a Routine Indirect Restoration Impression on a Challenging Patient Using a Dry Field Illuminator

“…24 With the dry field illumination technique, the clinician will need to adapt either a stock tray or a previously fabricated custom tray ( Figure 5). In modifying the tray it is important to include as many teeth as possible in the impression.…”

Dental management of patients with microstomia. A review of the literature and update on the treatment.

“…In the latter microstomia may be associated with radiotherapy as an additional factor that can damage the masticatory muscles limiting their mobility 13,14 . In some cases when the masticatory muscles or the temporomandibular joint become damaged a protective reflex contracture may occur reducing oral aperture and, sometimes, mobility can be accompanied by pain.…”

“…Among its clinical manifestations we find the appearance of Raynaud's phenomenon (deformities in the fingers and toes), fibrotic skin complications, in skeletal muscles, in the gastrointestinal tract, lungs, kidneys and cardiovascular system. Involvement of the orofacial tissues is characteristic in these patients, leading to a tense and mask-like facial skin and reduced oral aperture 7,14,16,17 . Microstomia also occurs in patients with epidermolysis bullosa.…”

“…In many cases it is preferable to obtain preliminary impressions, followed by the use of individualized trays, modified to obtain definitive impressions 17,40,47 . Many authors propose the use of sectioned trays to facilitate improved intraoral insertion and subsequent relocation of the sections outside the mouth 14,17,48,49 .…”