Microstomy: etiology, photo, orthopedic methods of treatment (prosthetics)

Microstomy (mikro - micro, stoma - mouth) is a developmental anomaly characterized by a narrowing of the oral opening. It develops as a result of mechanical stress or intrauterine disorders.

With the development of such a disease, scars appear on the mucous side of the mouth, which affect the soft tissues in the cheek area, which causes the "tightening" of the mouth gap.

Etiology of the disease

Microstomy forms:

1. Congenital - a rare form that develops due to a violation in the development of the fetus inside the womb.
2. Acquired - appears during life in connection with certain reasons.

An acquired microstomy can never become hereditary or be transmitted through contact with a sick person.

Reasons for the acquired form:

• mechanical impact on areas that are near the mouth;
• operations to change the appearance;
• surgery to remove a tumor on the face or osteomyelitis;
• burns that can be localized on the face;
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• purulent inflammation, ulcerative processes;
• tuberculous lupus;
• systemic scleroderma.

A person with a microstomy is limited in opening the mouth, eating, and even speaking.

Symptoms that cannot be overlooked

A person without specialized education may note symptoms such as:

• inability to eat and bite;
• external changes on the face, features become coarser;
• the mouth becomes smaller.

On examination, the doctor may note:

• changes in the system of teeth and jaw;
• narrow mouth gap.

Symptoms of a microstomy in the photo:

Treatment methods

There are several treatment options for this disease:

• surgical;
• orthopedic.

When choosing a treatment method, the state of the mouth matters. Before the prescribed treatment, the dentist must:

• conduct a visual inspection and with the help of specialized equipment;
• remove formed plaque on teeth;
• cure all teeth that need it.

Surgical

This treatment is a priority for those who have received a microstomy due to a burn or purulent formation.

Stages of surgical intervention:

1. Introduction anesthesiaso that the patient loses sensitivity.
2. Cutting the formed adhesions.
3. Restoration of the normal level of the mouth. This is done only with cuts every 1-2 centimeters, depending on the distance.
4. They form a part of the skin in the form of a loop and hide behind the cheek.
5. The fabric is also formed from the top and bottom.
6. The inner part is turned inside out and attached to the cut parts.
7. For the formation of a normal lip, a hemmed part is applied to the formed wounds.

The use of surgical intervention in patients with long-term diseases, from which scars with a dense structure have already appeared, is strongly discouraged.

When prescribing a method of treatment, the doctor takes into account:

• the age of the patient;
• health status;
• the presence of performed operations and anesthesia.

For some diseases, it is forbidden to carry out operations, for example:

• with tuberculous lupus;
• leukemia;
• tissue disease, as a result of which the vessels and skin are affected.

In the hospital, the patient spends an average of 4 days, but it all depends on the state of health.

Treatment results:

a - pronounced eversion of the lower eyelids and severe microstomy; b - after the 1st stage of reconstruction: the eversion of the lower eyelids and microstomy were eliminated; c - after 3 stages of treatment: cicatricial deformity of the nose is eliminated and eyebrows are formed.

Orthopedic (prosthetics)

Prosthetics with a microstomy, it is forbidden to do with:

• loss of elasticity of the skin at the mouth;
• the presence of a growth on the face, formed from a burn, or of another nature.

For prosthetics, it is necessary to take an impression:

1. The specialized material is introduced into one of the areas (right or left).
2. After the material takes shape, it is taken out.
3. These stages are carried out from the other side.
4. Both designs connect and mold the model.

Orthopedic treatment methods are used when the disease is neglected. Prostheses can be either whole or collapsible. Collapsible are used when it is not possible to put the whole structure in the mouth. The structure is assembled directly in the mouth and it can consist of two or three parts, which are attached to each other by tubes or specialized pins. The fastening system in this case is telescopic (one of the most reliable).

The size of structures can be influenced by:

• the presence of scars, their density and size;
• condition of the teeth;
• the nature of the disease (initial or advanced).

In addition to the collapsible prosthesis, there is also a folding fixing one. It consists of two parts, which are connected to each other by a front element. Install in this way:

• part of the mouth;
• install the prosthesis, fixing it on the jaw.

The most important point in the treatment of microstomy is the choice of the prosthesis design. It should not harm the patient in the process of eating and following the rules. oral care.

The structures to be installed should be as small as possible and as comfortable as possible.

Prosthetics with non-removable prosthetic constructions of dental crown defects and partial loss of teeth in the posterior regions is difficult in relation to local anesthesia and tooth preparation under the crowns. Sometimes do bridges does not seem possible.

Withdrawal prints with microstomy is complicated by the loss of elasticity of the soft tissues surrounding the mouth opening. Some patients have an alveolar ridge defect or mandibular contracture.

For patients with microstomy removable dentures are made with a reduced basis. It is recommended to use a cast metal base. With a microstomy, the impression taking method has nuances. It is determined according to the size of the mouth opening. The impression can be obtained using a standard children's spoon or a regular spoon, which is sawn into two halves. Impressions are taken separately from each side, after which the model is connected and cast. The base is made separately for the right and left half of the jaw. Sometimes the two prosthetic halves are connected by protacryl directly in the mouth.

Forecast

Microstomy is a serious condition. The sooner the patient seeks help, the lower the likelihood that the defect will change its appearance.

Early surgical or orthopedic treatment will not leave a trace of the disease.

For a long time, existing scars cause deformation of the dentition and disfigurement of the face, which leads to mental disorders. All this makes it difficult to choose a design and perform orthopedic manipulations. Sometimes it is difficult for a doctor to establish psychological contact with a patient.

The prognosis is also influenced by the age of the patient.

Prophylaxis

There are no specific measures for the prevention of microstomy.

Non-specific include:

1. Pregnancy planning and a healthy lifestyle. It is strictly forbidden to smoke, drink alcohol, be nervous.
2. You need to be more careful to protect yourself from mechanical injury and damage.
3. With a minimal change in the mouth, it is necessary, without delay, to seek help from a specialist.

If constructions were used in the treatment, then they should be monitored. fixation and hygiene, they should not swing and pop out.

All injuries that can cause a microstomy must be treated and shown to the doctor in time.