TRAUMA FOR THE USE OF MALADAPTIVE PROSTHESIS: CLINICAL CASE REPORT

The purpose of this study is to address traumas in the oral cavity due to the use of removable or total prostheses, that either fit poorly into the oral cavity or are  incorrectly sanitized by the patient. We highlight the need for a Surgical Dentist to perform possible corrections, and to perform a follow-up of the patient after the procedure. It is noteworthy that lesions such as ulcers and gum overgrowths can be avoided satisfactorily if the dental surgeon is able to perform an adequate treatment after the installation. A dental surgeon should be qualified to establish the real need for correction. His close interaction with the patient is the main point for the success of the work.


INTRODUCTION
Prosthetic Dentistry is a specialty that aims to guarantee the oral rehabilitation of areas of the oral cavity that lack teeth, by way of implanting artificial devices (DESPLATS; KEOGH, 1998). The objectives are to eliminate diseases in the oral cavity, to restore damaged areas in the oral cavity in general, and to promote the maintainance of teeth that still remain in the oral mucosa (CARR; MCGIVENY; BROWN, 2005).

LITERATURE REVISION
The success in the implementation of a partial dental prosthesis is directly related with the clinical and laboratorial stages of preparing the prosthesis, and on the subsequent coparticipation of the patient, that needs to maintain a satisfactory buccal sanitation (CONTI et al., 1991).
Lesions in the buccal mucosa are prevalent in cases of patients using removable prostheses. Among the common lesions we highlight candidiasis, inflammed gum overgrowths, and traumatic ulcers. Frequently the incidence of these lesions were due to the patient being unaware of the necessity of following rules of sanitation and of adequate use, such as frequency and extent of use (GONÇALVES et al., 2011). With the onset of old age, there occurs a reduction in the salivar flux, which may occasionally provoque pain, adherence of the tong onto the base of the prostheses, or lack of retention of the device, all of which may contribute to form lesions in the buccal cavity (TELES, 2010).
Taking the above points into consideration, the aim of this article is to document a case of trauma provoked by a badly fitting dental prosthesis.

CLINICAL CASE REPORT
The patient, Mr. J.S.F, aged 51 years old, uses a prosthetic model for over 10 years. He reported a great difficulty to adapt to his old prosthesis. The prosthesis used by this individual revealed several problems, such as its design, which contributed to the difficulty reported by the patient in chewing. It was also oberved that his speech was impaired. The phonetic changes were provoked by the incorrect placement of the prosthesis in the mouth. The patient also had aesthetical complaints. The prosthesis made the face appear smaller, which caused apparent aging. Added to these problems, the prosthesis had problems in its physical construction, provoking lesions in areas of the gum that made contact with the dental device, producing daily injuries on the roof of the buccal cavity when chewing (Figs. 1, 2, 3). All these problems compromised the well beying of the patient, and in the long run could provoque more serious pathologies.
To solve this problem, the scheme "etyology, pathology and treatment for cases of prosthesis traumatism" was followed (Fig. 4). Due to the ulcerations observed in the patient, a new prosthesis was made, which brough relief to the patient.

CONCLUSIONS
Lesions usually receive a favorable prognoses. There are no reports of malignous lesions, yet it is necessary for the Surgical Dentist to intervene in order to contain the progression of the lesion. He is required to make the necessary adjustments and to produce a new prosthesis.