Dr. K. asks:
I have a patient with a severe case of scleroderma. She can open only about 20mm without experiencing pain. I cannot insert an impression tray in her mouth no matter how I twist it or load it. She has lost most of her teeth and I expect she will eventually loose the remaining teeth. I would like to make diagnostic casts to determine how best to restore her with implants. How do I make impressions? Is scleroderma a contraindication to dental implants? Will scleroderma effect the prognosis in any way? I have not been able to find any literature on this. Any help would be appreciated.
Scleroderma: Contraindication to Dental Implants?
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Dr. K. Can I assume this is some kind of joke post.
If the patient can’t open enough for impressions how were you planning on restoring these implants, let alone placing them?
If the patient can’t open enough for her and her dentist to maintain her teeth, how is she going to maintain her implants?
Is scleroderma a contraindication to implants? Well if the mouth opening is insufficient to place implants, then I guess you’ve answered your own question!
Kind Regards,
Bill Schaeffer
If you can not get an impression tray into the mouth, you will not be able to do any of the following:
1. Get the surgical drill and implants in her mouth.
2. Be able to restore any implants already there.
3. Deal with any future complications.
I would consider different treatment if I were you.
Russell
Good luck, in a couple these patients, to remove abscess teeth, I’ve had to do a commissurotomy just to access the teeth. Not only is there restriction, but lack of elasticity of the skin (part of the disease) and the cheek are therefore not compliant.
remember C.R.E.S.T for systemic scleroderma?????
I have two scleroderma patient placed multiple implants.İf patient have sufficient mouth opening you can put implants without any further problems..İmplants are helps these patients a lot…because by the time mouth opening is more limited.So it isbetter to do it as much as earlier.İmplants also help the patients cheek elasticity..and they are appreciate so much…
I have placed several implants into a single scleroderma patient without problem except access and angulation. The tissues healed normally and the implants integrated well. The restorative dentist used Easy abutments(Nobel) thus making impressiion taking a little easier. The case is doing nicely after 8 or 9 years function. Your biggest concern will be access for both implant surgery and restorative procedures.
What type of scleroderma does your patient have? Are there any renal or pulmonary complication history? Is she under medication? Will these effect the indication of surgical approach and/or possible medication if need to use emerges?
Besides, what is the exact dental situation? What is/are the causes for teeth loss? How well is the patient motivated to oral hygiene measures? If it seems possible to place implants, will it be possible to place them only in anterior region to support an overdenture?
This disease is known to be th1 and associated with cwd bacterias. If the patient in on abx they should do well. If not they should check into th1 diseases and abx. Lee
I’ve read 2 or 3 articles from journal prosthetic dentistry about how to make impression for scleroderma patient. The author make sectional impression tray. You can google that articles. Vin
Hi all can you not put these patients under general
To do the work if the can’t open their mouths. Whilst
I know it’s not ideal but neither is having the
Disease in the first place! ?