J Gringer
| J Gringer |
Casey Gringer
Marc Henschel
Oral Medicine, University of Pennsylvania School of Dental Medicine
Introduction
Down Syndrome is a multifactorial disease that results in several distinct cognitive, behav-ioral and physical downstream affects. This disease is associated with mild to moderate intellectual disability, physical growth delays & distinct facial features. Regarding the oral cavity, many of these physical and behavior characteristics can deter and inhibit efficient and effective treatment. Macroglossia, rampant periodontal disease and odontogenic agenesis are all common oral manifestations of this dis-ease, all of which can affect long-term care of these patients.
Methods
Our patient is a 24-year-old woman who suf-fers from this disease. She presented to the Penn Dental Medicine Care Center for Persons with Disabilities with an almost entirely eden-tulous maxillary arch and an inability to chew efficiently as a result. Having been previously edentulated by an outside dentist, our patient was in need of a prosthesis. As expected with this patient population, she had an inability to tolerate traditional means of fabricating a pros-thesis. Macroglossia, long-spanning eden-tulism and the inability to behaviorally tolerate conventional treatment, created difficulties in traditional fabrication of a prosthesis.
Results
Patient presented with a retained microdont at the maxillary midline after both upper and lower full mouth extractions due to non-restorable decay throughout the dentition. A few weeks after the extraction a digital scan of both the upper and lower edentulous arches was completed with CEREC’s primescan. Then using CEREC digital design software we were able to create an upper and lower 3D printed resin models to use as a traditional wax-try in to determine esthetics, phonetics and occlusion. After the Maxillo-Mandibular relation was captured and a proper bite-registration was achieved we took all the com-ponents back to the digital design lab to manu-facture, mill and finish the final prothesis.
Conclusion
Using burgeoning 3D scanning technology, the patient was able to be digitally scanned and a prosthesis made using advanced 3D printing methods and materials. We were able to effec-tively treat this patient, fabricate a prosthesis using cutting-edge technology and treat this specialized patient population in a caring and efficient manner. This is a perfect example of the advent of the digital dental age and our ability to shift the paradigm of treatment in this patient population. We hope this case begins to allow the general practitioners to take on chal-lenging cases to better serve the greater patient population.