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Journal of Indian Prosthodontic Society 2016The Prosthetic rehabilitation of microstomia patients presents difficulties at all the stages. The difficulty starts with the preliminary impression making. This is due... (Review)
Review
The Prosthetic rehabilitation of microstomia patients presents difficulties at all the stages. The difficulty starts with the preliminary impression making. This is due to the tongue rigidity and the decreased oral opening. A maximum oral opening which is smaller than the size of the tray can make prosthetic treatment challenging. Due to the restricted mouth opening, insertion and removal of the impression trays is extremely cumbersome and various modifications of the trays have been used in the past. Among these are the flexible trays and the sectional trays used with different modes of reassembling the segments extra orally after the impression is made. This article reviews the literature published from 1971 to 2015 concerning preliminary impression techniques used in making impressions for patients with microstomia based on various tray designs. An electronic search was performed across three databases (PubMed, Science Direct and Google Scolar) for relevant citations. The keywords/combinations used for the search were microstomia, limited/constricted/restricted mouth opening/oral access, trismus, sectional trays, impressions and prosthetic/prosthodontic rehabilitation. The search was limited to papers written in English which resulted in a total of 45 related articles of which 17 articles were included for discussion of this review.
PubMed: 27621540
DOI: 10.4103/0972-4052.186400 -
Dermatologic Surgery : Official... Jun 2021Most patients with scleroderma suffer from microstomia, which can have debilitating consequences on their quality of life. Unfortunately, treatment options remain... (Review)
Review
BACKGROUND
Most patients with scleroderma suffer from microstomia, which can have debilitating consequences on their quality of life. Unfortunately, treatment options remain limited. No specific guidelines exist; hence, microstomia remains a challenge to treat in this patient population.
OBJECTIVE
This review aims to evaluate the different medical and surgical treatment modalities currently available for microstomia in patients with scleroderma and make recommendations for future research.
MATERIALS AND METHODS
A search of PubMed, Ovid MEDLINE, and Ovid Embase was conducted to identify articles discussing the treatment of microstomia in scleroderma. Twenty articles discussing surgical therapy and one article discussing medical therapy were reviewed.
RESULTS
Mostly because of a scarcity of high-level evidence, no individual therapy has documented long-term efficacy. Some treatments demonstrate positive results and warrant further research.
CONCLUSION
Given the variability of results, specific recommendations for the treatment of microstomia in patients with scleroderma are difficult to establish. A multifaceted approach that includes surgical and medical therapy is likely the best option to improve oral aperture in this patient population. Surgical treatments such as neurotoxins, autologous fat grafting, and ultraviolet A1 phototherapy may hold the most potential for improvement.
Topics: Adipose Tissue; Facial Muscles; Humans; Microstomia; Mouth; Neurotoxins; Quality of Life; Scleroderma, Systemic; Transplantation, Autologous; Treatment Outcome; Ultraviolet Therapy
PubMed: 33867466
DOI: 10.1097/DSS.0000000000002995 -
The Journal of Prosthetic Dentistry Apr 1989Eighteen microstomia orthoses are compared with respect to their characteristics, use, and limitations. A new prosthesis, the Vancouver microstomia orthosis, was... (Comparative Study)
Comparative Study Review
Eighteen microstomia orthoses are compared with respect to their characteristics, use, and limitations. A new prosthesis, the Vancouver microstomia orthosis, was designed to incorporate the advantages of many of the orthoses and eliminate some drawbacks. Ten adults with microstomia secondary to second- or third-degree circumoral flame burns were fitted with the prosthesis and observed over a 12-month period. In 9 weeks or less, microstomia was corrected with an average gain of 7 mm in the horizontal and 13 mm in the vertical active range of motion. The measures before and after this treatment were statistically significant for increase in both dimensions (paired t-test, p less than .01).
Topics: Adult; Burns; Equipment Design; Facial Muscles; Female; Humans; Male; Microstomia; Middle Aged; Mouth; Mouth Diseases; Orthotic Devices; Physical Therapy Modalities; Pilot Projects; Plastics; Splints
PubMed: 2657012
DOI: 10.1016/0022-3913(89)90019-x -
Archives of Craniofacial Surgery Jun 2020Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral...
BACKGROUND
Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature.
METHODS
The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction.
RESULTS
Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good.
CONCLUSION
Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.
PubMed: 32630987
DOI: 10.7181/acfs.2020.00220 -
Indian Journal of Dental Research :... 2009Microstomia is defined as an abnormally small oral orifice which can be due to various factors. Microstomia is a definite prosthodontic hindrance to carry out the... (Review)
Review
Microstomia is defined as an abnormally small oral orifice which can be due to various factors. Microstomia is a definite prosthodontic hindrance to carry out the different treatment successfully. To rehabilitate a patient with microstomia, successfully, the methods and designs incorporated in the prosthesis have to be modified. In the past, various techniques have been tried, incorporating certain biological and scientific methods to rehabilitate patients with microstomia. This article reviews the previously described treatment modalities in case of patients with microstomia.
Topics: Dental Impression Technique; Denture Design; Denture, Complete; Humans; Jaw, Edentulous; Microstomia
PubMed: 20139576
DOI: 10.4103/0970-9290.59458 -
Journal of Rehabilitation Research and... 1987Microstomia is a complication of facial burns, traumatic injuries, scleroderma, or surgical reconstructions involving the oral aperture. A variety of orthoses for the... (Review)
Review
Microstomia is a complication of facial burns, traumatic injuries, scleroderma, or surgical reconstructions involving the oral aperture. A variety of orthoses for the correction or prevention of microstomia are offered by dentists, occupational therapists, physical therapists, and other specialists. This paper provides an overview of the structural and clinical features of 12 common tissue-borne or tooth-borne microstomia appliances. The review is intended to facilitate the selection of suitable orthoses, and to indicate the need for interdisciplinary management of microstomia patients.
Topics: Humans; Microstomia; Mouth Diseases; Orthotic Devices
PubMed: 3305875
DOI: 10.1682/jrrd.1987.07.0035 -
Journal of Maxillofacial and Oral... Jun 2021Caustic soda ingestion causes strictures in the respiratory, gastrointestinal systems and even death. In the oral and perioral areas it causes contractures leading to...
Caustic soda ingestion causes strictures in the respiratory, gastrointestinal systems and even death. In the oral and perioral areas it causes contractures leading to microstomia that is difficult to manage to restore structure and function of the oral cavity. The present case is of a 42-year-old female who presented with microstomia, no endoscopic esophageal injury and ankyloglossia following ingestion of caustic soda in an attempted suicide following a dispute with her spouse. Satisfactory mouth opening and tongue movement were achieved by bilateral release of buccal contractures, commissuroplasty and release of the tongue that was tethered to the floor of the mouth.
PubMed: 33927490
DOI: 10.1007/s12663-019-01247-4 -
Ryoikibetsu Shokogun Shirizu 2001
Review
Topics: Abnormalities, Multiple; Ear, External; Humans; Jaw Abnormalities; Microstomia
PubMed: 11462378
DOI: No ID Found -
Pediatric Dentistry 1997Perioral burns may occur due to electrical, thermal, or chemical agents. The resultant contracture of the facial tissue during healing causes limited oral access,... (Review)
Review
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.
Topics: Age Factors; Burns; Burns, Chemical; Child, Preschool; Contracture; Cost-Benefit Analysis; Electric Injuries; Equipment Design; Esthetics; Facial Injuries; Humans; Microstomia; Mouth; Mouth Protectors; Wound Healing
PubMed: 9348607
DOI: No ID Found -
Journal of Maxillofacial and Oral... Dec 2013Freeman-Sheldon syndrome (FSS), as first described by Freeman and Sheldon in 1938, is a morphologically well-defined syndrome that results in a dysmorphic status... (Review)
Review
Freeman-Sheldon syndrome (FSS), as first described by Freeman and Sheldon in 1938, is a morphologically well-defined syndrome that results in a dysmorphic status combining bone anomalies and joint contractures with characteristic facies. It is part of the nosologic group of pathologies currently known as distal arthrogryposis as reported by Hall et al. (Am J Med Genet 11:185-239, 1982 [1]). It is a rare disorder and its exact prevalence is unknown. Our objective is to report a case of FSS presenting with microstomia and add a brief review of the literature for similar cases.
PubMed: 24431877
DOI: 10.1007/s12663-012-0392-4