Semi-Digital Workflow of Removable Partial Denture Fabrication for Scleroderma-Induced Microstomia Patients: Two Clinical Reports

Scleroderma is a chronic connective tissue disease characterized by collagenous fibrosis resulting in the hardening and contracture of the skin and mucosa. Most of the scleroderma patients develop Raynaud's phenomenon that the fingers and toes feel numb, prickly and frigid in response to cold temperatures or stress. Due to fibrosis of the skin and soft tissues, scleroderma induces microstomia that clinically represents limited mouth opening which results in difficulty both for the patients and the dentists. Limitation of lip and tongue movements, xerostomia, gastroesophageal reflux disease, myofascial pain, dysgeusia, and periodontal problems are the most common oral health issues in scleroderma patients. Prosthetic rehabilitation of patients with a small oral orifice, such as scleroderma-induced microstomia may present difficulties. Patients with microstomia often complain of an inability to insert or remove dentures. This clinical report describes the semi-digital workflow of prosthetic rehabilitation of two partially edentulous patients with scleroderma-induced microstomia. Intraoral scanning was used for impression making and models were printed using a 3D printer. Both patients received a conventional removable partial denture. Intraoral scanning can be an alternative to conventional impression-making techniques and can be used safely in patients with microstomia for impression making.