Prosthodontic treatment modalities for microstomia patients: A systematic review / Khairini Nordin

Khairini , Nordin (2024) Prosthodontic treatment modalities for microstomia patients: A systematic review / Khairini Nordin. Masters thesis, Universiti Malaya.

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Abstract

Microstomia, a condition characterized by a reduced oral aperture size, posed challenges in dental procedures and prosthetic rehabilitation. This systematic review critically evaluated published case reports and case series related to the prosthodontic treatment of microstomia. The review identified the most common methods for measuring the severity of microstomia and suggested appropriate treatment options tailored to the severity of the condition. Using the PICO framework, the study reviewed English publications up to May 2024, emphasising only on mouth opening assessments and treatments while excluding temporomandibular joint issues. The search methodology encompassed multiple electronic databases, including PubMed, Medline, EBSCO host, Scopus, and Web of Science, using keywords and MESH terms: microstomia, limited oral opening, limited oral access, prosthodontic, and prosthesis. Data extraction was followed by a standardised process, verified by multiple reviewers for accuracy. The findings of this review revealed that the most adopted approach to measure maximal mouth opening (MMO) in microstomia patients was the lip-to-lip technique for edentulous and combination cases, while the interincisal technique was predominantly used for partially dentate patients. After removing all duplicates and screening, the total articles were 82 case reports, of which 15 were excluded due to insufficient details such as a lack of follow-up regarding patient outcomes. The correlation analysis was conducted using the remaining 67 reports. The Fisher Exact Test indicated that there was no significant correlation between the severity of microstomia and the choice of prosthodontic treatment approaches. None of the authors used conventional dentures for cases with a severely reduced maximum mouth opening (less than 20mm for edentulous and less than 25mm for partially dentate or combination). In conclusion, the lip-to-lip technique is the most common way to measure maximal mouth opening (MMO) for edentulous and combination cases, while the interincisal technique was preferred for partially dentate patients. There was no significant link between the severity of microstomia and the treatment chosen. Therefore, more research is needed to better understand this relationship.

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