Full mouth reconstruction in a patient after radiotherapy treatment

 
林嘉威  朱勗維  鄭偉立  賈景山
台大醫院 牙科部
 

      This 53 y/o female patient was a victim of nasopharyngeal carcinoma and had been treated with radiotherapy about 15 years ago. She’s been under regular follow-up and topical fluoride medicament. However, post-irradiation change of tooth structure still occurred. Due to esthetic consideration, she wanted to have full mouth prostheses reconstruction. Although patient kept her oral hygiene and used fluoride treatment every day .The clinic examination still shows generalized erosion and abrasion found in patient’s remaining teeth. Such condition becomes a esthetic problem since the anterior teeth are largely involved , especially when she smiling. As to the patient’s missing posterior teeth, we will take new prosthesis fabrication into consideration. Besides other post-irradiation change are also noted : the limited mmo will be a problem for impression during prosthesis fabrication : Xerostomia and fragile oral mucosa may cause removable prosthesis easily interfering patient’s mucosa. Full mouth radiographic image shows radiolucency in many remaining teeth, endodontic evaluation and treatment are needed.
     In such a case, we noted that post-irradiation change of tooth structure will proceeded since regular post-irradiation care. Different prosthesis we can provided for such patients will have different advantage and greatly influence patient’s esthetic and function. Post -irradiation change of soft tissue and patient’s desirable aspect must also be emphasized. Therefore, we designed and delivered a full-mouth reconstruction treatment scheme for this patient and presented in this poster.