Region Jnkpings ln Odontologiska Institutionen
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Oral rehabilitation with dental implants in a patient with dystrophic epidermolysis bullosa and Alport syndrome

Hadjikani M*,  Ericson M,  Bergendal  B  
 

Objectives

The aim was to present the oral rehabilitation with tooth- and implant-supported fixed prostheses in an adult male patient with dystrophic epidermolysis bullosa(EB) and Alport syndrome. EB had caused synechial fibrosis of the oral mucosa and microstomia. As a consequence of Alport syndrome the patient had total renal failure and home dialysis, and was waiting for a kidney transplantation.

Methods

The 56 yrs old patient presented with a compromised dentition, with carious lesions, residual roots and a loose fixed partial denture(FPD) in the lower jaw. Preprosthetic treatment comprised elimination of infection through caries excavation and extraction of residual roots. A temporary FPD was made in the upper jaw. Implant surgery was provided under conscious sedation and LA, and 5 implants were installed in the edentulous lower jaw. After 3 months of healing an implant-supported FPD was made.

Results

Lack of vestibular sulci posteriorly caused by synechial fibrosis in the oral mucosa, and reduced jaw opening of 25 mm were the main clinical difficulties. The oral mucosa was very sensitive to mechanical trauma, and after implant surgery there was severe blistering. No other complications occurred. Before treatment there was an overjet of 12 mm, which was reduced by angulation of the reconstruction in the lower jaw and the preparations of the frontal teeth in the upper jaw. Special attention was paid to the design of the FPDs in order to facilitate oral hygiene. The treatment greatly improved the possibility for adequate nutrition and the overall quality of life for the patient.

Conclusions

Bone quality seems to allow successful placement and healing of dental implants in individuals with EB. The clinical management must pay due respect to the fragility and risk for blistering of the oral mucosa. The case is an example of extensive dental treatment in a severely compromised individual.

Uppdaterad: 2013-04-03
Anna Thofelt, Avdelningen för odontologisk radiologi Jönköping, Folktandvården