Advertisement
Journal of Prosthetic Dentistry

Full arch monolithic zirconia prosthesis in a patient with bilateral cleft palate: A clinical report

Published:September 23, 2020DOI:https://doi.org/10.1016/j.prosdent.2020.05.016

      Abstract

      Adult patients with bilateral cleft lip and palate present unique challenges for prosthodontic treatment because of mobility of the premaxillary segment, oral-nasal communication, multiple missing and malpositioned anterior teeth, unfavorable soft tissues, and scar tissue underneath the maxillary lip. This clinical report describes the prosthodontic treatment of an adult patient with a terminal maxillary dentition and bilateral cleft palate, by using 5 dental implants and a 1-piece complete-arch fixed implant-supported prosthesis made of monolithic zirconia. The zirconia prosthesis aided in rigidly splinting not only the implants but also in orthopedically splinting the mobile premaxillary segment to the maxilla. Additional surgical and prosthodontic considerations in splinting the mobile premaxilla as well as biomechanical principles involved in management of such patients are also presented in this article.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Güven O.
        • Gürbüz A.
        • Baltali E.
        • Yilmaz B.
        • Hatipoglu M.
        Surgical and prosthetic rehabilitation of edentulous adult cleft palate patients by dental implants.
        J Craniofac Surg. 2010; 21: 1538-1541
        • Reisberg D.J.
        Prosthetic habilitation of patients with clefts.
        Clin Plast Surg. 2004; 31: 353-360
        • Reisberg D.J.
        Dental and prosthodontic care for patients with cleft or craniofacial conditions.
        Cleft Palate Craniofac J. 2000; 6: 534-537
        • Bitterman G.
        • Ruiter A.
        • Janssen N.
        • Bitterman A.
        • van der Molen A.
        • van Es R.
        • et al.
        Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?.
        Clin Oral Investig. 2016; 20: 207-217
        • Bennum R.
        • Harfin J.
        Bilateral cleft lip and palate, with facial dysplasia: interdisciplinary treatment and long-term follow-up.
        J Craniofac Surg. 2018; 29: 1441-1444
        • Bidra A.S.
        Esthetic and functional rehabilitation of a bilateral cleft palate patient with fixed prosthodontic therapy.
        J Esthet Restor Dent. 2012; 24: 236-244
        • Bergland O.
        • Semb G.
        • Abyholm F.E.
        Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment.
        Cleft Palate J. 1986; 23: 175-205
        • van der Meij A.J.
        • Baart J.A.
        • Prahl-Andersen B.
        • Kostense P.J.
        • van der Sijp J.R.
        • Tuinzing D.B.
        Outcome of bone grafting in relation to cleft width in unilateral cleft lip and palate patients.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 19-25
        • Kokai S.
        • Fukuyama E.
        • Sato Y.
        • Hsu J.C.
        • Takahashi Y.
        • Harada K.
        • et al.
        Comprehensive treatment approach for bilateral cleft lip and palate in an adult with premaxillary osteotomy, tooth autotransplantation, and 2-jaw surgery.
        Am J Orthod Dentofacial Orthop. 2015; 147: 114-126
        • Hakan Tuna S.
        • Pekkan G.
        • Buyukgural B.
        Rehabilitation of an edentulous cleft lip and palate patient with a soft palate defect using a bar-retained, implant-supported speech-aid prosthesis: a clinical report.
        Cleft Palate Craniofac J. 2009; 46: 97-102
        • Balshi T.J.
        The Biotes conversion prosthesis: a provisional fixed prosthesis supported by osseointegrated titanium fixtures for restoration of the edentulous jaw.
        Quintessence Int. 1985; 16: 667-677
        • Bidra A.S.
        • Tischler M.
        • Patch C.
        Survival of 2039 complete arch fixed implant-supported zirconia prostheses: a retrospective study.
        J Prosthet Dent. 2018; 119: 220-224
        • Sawaki M.
        • Ueno T.
        • Kagawa T.
        • Kanou M.
        • Honda K.
        • Shirasu N.
        • et al.
        Dental implant treatment for a patient with bilateral cleft lip and palate.
        Acta Med Okayama. 2008; 62: 59-62