J Korean Acad Prosthodont.  2019 Jan;57(1):81-87. 10.4047/jkap.2019.57.1.81.

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

Affiliations
  • 1Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea. prosth95@knu.ac.kr

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.

Keyword

Down's syndrome; Cross bite; Double crown; Partial denture

MeSH Terms

Adult
Anesthesia
Anesthesia, Dental
Crowns*
Dental Anxiety
Dental Enamel
Dental Enamel Hypoplasia
Dentin
Denture, Partial
Dentures*
Down Syndrome*
Female
Humans
Malocclusion*
Mandible
Maxilla
Palate
Periodontitis
Tooth
Tooth, Deciduous

Figure

  • Fig. 1 Initial panoramic radiograph of the patient with Down's syndrome.

  • Fig. 2 (A) Intra-oral frontal view and (B) lateral view of the patient with Down's syndrome.

  • Fig. 3 Maxillary impression and bite registration. (A)Border molding, (B) Impression, (C) Resulted stone cast, (D) Bite registration.

  • Fig. 4 Mandibular teeth preparation and gingival retraction with cord. (A) Whole occlusal view, (B) Right view, (C) Left view.

  • Fig. 5 (A) Bite registration, (B, C) Mounting of cast.

  • Fig. 6 Maxillary master cast with inner crown. (A) Occlusal view, (B) Frontal view.

  • Fig. 7 Maxillary pick up impression. (A) Inner crown splinting with pattern resin, (B) Pick up impression.

  • Fig. 8 (A) Maxillay inner crown, (B) Wax rim with outer crown.

  • Fig. 9 (A) Determination of vertical dimension, (B) Bite registration.

  • Fig. 10 (A) Trial setting of mandibular laminate and crown, (B) Bite registration.

  • 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.

  • Fig. 12 Double crown denture delivery. (A) Maxillary occlusal view, (B) Frontal view.


Reference

1. Shajpal A, Siddiqui F. Screening for Down syndrome. Obstet Gynaecol Reprod Med. 2017; 27:333–337.
Article
2. Roizen NJ, Patterson D. Down's syndrome. Lancet. 2003; 361:1281–1289.
Article
3. Crawford D, Dearmun A. Down's syndrome. Nurs Child Young People. 2016; 28:17.
Article
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.
Article
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.
Article
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.
Full Text Links
  • JKAP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr