[Prosthetic treatment of patient with multiple sclerosis (MS) and intact masticatory function (case report)]

Comprehensive dental care of functionally dependent patients requires particular attention because of the following conditions: invariably a poor general health status leading to a reduced demand for any essential dental or prosthetic care, poor socio-economic circumstances, and a lack of support services. The purpose of this paper, through a case report, is to highlight the positive effect of prosthetic treatment on the quality of life. The patient, a 46-year-old female suffering from SM, was referred to our clinic by her general practitioner. Both intra-oral and x-ray examinations indicated a severely neglected state of dental health including a large number of carious lesions, and advanced periodontal disease. On the basis of these findings all of her remaining teeth were removed. Six weeks following surgery a start was made to make a full, removable denture using the conventional technique. When taking the functional impression, borders of the custom tray were extended as far as possible to fully accommodate the denture bearing mucosa. This functional adaptation along the posterior border of the upper tray led to a significantly greater palatal seal thereby greatly increasing stability of the upper denture. An acceptable retention of the lower plate was achieved by utilizing tongue function with the modelling compound. Taking into consideration functional tooth positioning and biomechanical principles, the occlusal plane was positioned close to the lower alveolar ridge, and then a bilateral balance and lingualised occlusion were performed. Following polymerisation of the denture base, the remontage technique was used to modify the balanced forced occlusion. By using the conventional technique and taking into account particular biomechanical and psychosocial considerations, the successful masticatory functions of the patient were achieved. To achieve an optimal prognosis, priorities should be determined during the treatment planning stages.