Abstract
Patient: This study reports on a female patient with cerebral palsy, who was 28 years old when she first visited our clinic. At the age of 18, a bridge was set in the maxilla with the treatment performed under general anesthesia at University Dental Hospital. After 10 years, the bridge came off because of abutment tooth fracture. After tooth extraction, the feasibility of removable prosthesis was verified by using a temporary denture without clasps and performing careful occlusal adjustment, to achieve denture stability in the presence of unconscious lateral movements of the mandible. It was judged that the removable prosthesis could be used in this case and it was decided to fabricate a telescopic prosthesis. As a countermeasure for the patient's unconscious mandibular movements, the occlusion of the temporary denture was transferred as precisely as possible to the final prosthesis, and the palatal denture plate was reinforced by a metal framework to prevent fracture.
Discussion: Due to the taper of the inner caps, the telescopic prosthesis could be easily inserted in and removed from the patient's mouth. Prosthesis retention was achieved only in the final stage of prosthesis insertion and it was continuously maintained at an appropriate level. Furthermore, with this type of prosthesis, abutment teeth can be easily accessed for cleaning. For all these reasons, the telescopic prosthesis is considered to have many advantages for handicapped patients with unconscious mandibular movements. Moreover, the rigid connection between denture base and abutment teeth ensured rigid support, avoiding stress concentration in specific areas and thus providing the basis for favorable long-term prognosis of the treatment.
Conclusions: Good results were achieved after 12 years in a patient with cerebral palsy, whose large edentulous space was treated with a telescopic denture. Thus, this case shows that it is possible to treat large edentulous spaces of handicapped patients by using a removable prosthesis.
