Journal List > J Korean Acad Prosthodont > v.57(1) > 1121608

Doh and Cho: Prosthetic treatment for Down's syndrome patient with dental cross bite problem using maxillary double crown denture

Abstract

Patients with Down's syndrome have several dental complications such as small teeth caused by underdevelopment of dentin and enamel, periodontitis, agenesis of teeth, prolonged retention of primary teeth and malocclusion due to narrow palate. Removable denture with maxillary double crowns would be a good treatment option to solve the problems of the patient with Down's syndrome. Double crowns compensate the insufficient support and retention of denture and easily solve the cross bite problem. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 26-year-old female patient with Down's syndrome and dental phobia had small number of teeth with enamel hypoplasia, prolonged retention of primary teeth and dental cross bite. Prosthetic treatment was done using removable denture with double crowns in the maxilla. In the mandible, teeth preparation was done on enamel margin without anesthesia. Anterior laminate and posterior complete zirconia crown restorations were performed. As a result, the cross bite was effectively corrected by denture with double crowns. Pronunciation and appearance were also improved without extraction of teeth and dental anesthesia.

Figures and Tables

Fig. 1

Initial panoramic radiograph of the patient with Down's syndrome.

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Fig. 2

(A) Intra-oral frontal view and (B) lateral view of the patient with Down's syndrome.

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Fig. 3

Maxillary impression and bite registration. (A)Border molding, (B) Impression, (C) Resulted stone cast, (D) Bite registration.

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Fig. 4

Mandibular teeth preparation and gingival retraction with cord. (A) Whole occlusal view, (B) Right view, (C) Left view.

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Fig. 5

(A) Bite registration, (B, C) Mounting of cast.

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Fig. 6

Maxillary master cast with inner crown. (A) Occlusal view, (B) Frontal view.

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Fig. 7

Maxillary pick up impression. (A) Inner crown splinting with pattern resin, (B) Pick up impression.

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Fig. 8

(A) Maxillay inner crown, (B) Wax rim with outer crown.

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Fig. 9

(A) Determination of vertical dimension, (B) Bite registration.

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Fig. 10

(A) Trial setting of mandibular laminate and crown, (B) Bite registration.

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Fig. 11

Fit checking of maxillary inner and outer crowns. (A) Maxillary inner crowns, (B) Internal surface of denture, (C) Fit checking of outer crown.

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Fig. 12

Double crown denture delivery. (A) Maxillary occlusal view, (B) Frontal view.

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References

1. Shajpal A, Siddiqui F. Screening for Down syndrome. Obstet Gynaecol Reprod Med. 2017; 27:333–337.
crossref
2. Roizen NJ, Patterson D. Down's syndrome. Lancet. 2003; 361:1281–1289.
crossref pmid
3. Crawford D, Dearmun A. Down's syndrome. Nurs Child Young People. 2016; 28:17.
crossref
4. van der Linden MS, Vucic S, van Marrewijk DJF, Ongkosuwito EM. Dental development in Down syndrome and healthy children: a comparative study using the Demirjian method. Orthod Craniofac Res. 2017; 20:65–70.
crossref pmid
5. Macho V, Palha M, Macedo AP, Ribeiro O, Andrade C. Comparative study between dental caries prevalence of Down syndrome children and their siblings. Spec Care Dentist. 2013; 33:2–7.
crossref pmid
6. Severin E, Paun A, Baltag R, Stan A, Funieru C. Common, rare, and individual oro-dental findings in people with Down syndrome. J Int Oral Health. 2016; 8:964–968.
7. Dawson PE. Functional occlusion: from TMJ to smile design. St. Louis: Mosby;2007. p. 114–131.
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ORCID iDs

Seok-Joo Doh
https://orcid.org/0000-0003-0620-0049

Jin-Hyun Cho
https://orcid.org/0000-0002-2453-9372

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