Prosthetic rehabilitation in a patient with systemic scleroderma

A 49-year-old patient with systemic scleroderma was referred to the Department of Dental prostheses for the Degree in Dentistry and Dental Prostheses at Florence University because he was unable to wear his existing complete dentures. The upper denture was not correct owing to the position of the artificial teeth and the short base, and the lower denture caused pain when used. A complete new dental prosthesis was therefore required to overcome the difficulties caused by this systemic disease. Scleroderma is a progressive disease that causes the anelasticity of the mesenchymal tissues owing to post-inflammatory fibrotic and degenerative alterations of unknown etiology. Important changes also occur in the mouth: difficulty opening the mouth, hypo- or non-extendibility of the soft perioral tissues. The construction of the complete upper and lower dentures posed a series of major technical problems compared to a patient not suffering from this pathology. The first core, the rimming of the individual core holder, calculating the vertical dimension and the assembly of the front teeth were all phases that required technical modifications and special care, so that the techniques of our School could be adapted to this particular case. The cosmetic and functional result was undoubtedly good. The patient has been wearing these dental prostheses for five years with satisfaction.