title: Complex prosthodontic treatment with dental implants for a patient with polymyalgia rheumatica: a clinical report.
abstract: Prosthodontic and implant treatment for a patient with polymyalgia rheumatica can be complicated not only by its symptoms, but also by the side effects of long-term use of certain medications, particularly systemic glucocorticoids. This clinical report presents a polymyalgia rheumatica patient who required full-mouth rehabilitation with dental implants. The patient had a sensitive gag reflex and refused the use of any removable prostheses. She presented clinically with a skeletal Class II malocclusion with severe overbite and overjet. All her remaining dentition was determined to be unrestorable. Full-mouth extractions and immediate placement of implants followed by early implant loading were performed. The use of systemic glucocorticoids might have exacerbated her type 4 maxillary bone and compromised her healing capacity and consequently made implant surgery challenging. Her treatment with full-arch fixed implant-supported dentures to correct her severe overbite and overjet and manage misaligned dental implants is summarized here. The effects of polymyalgia rheumatica in prosthodontic and dental implant treatments are reviewed and discussed.
authors.affiliation: Department of Prosthodontics, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA. Sompop_ Bencharit@dentistry.unc.edu
authors.forename: Sompop
authors.initials: S
authors.lastname: Bencharit
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Reside
authors.forename: Escher L
authors.initials: EL
authors.lastname: Howard-Williams
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications / Q000628:therapy; D000075202:Contraindications; D003758:Dental Implantation, Endosseous / Q000379:methods*; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003824:Denture, Complete; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000150:complications* / Q000534:rehabilitation; D009066:Mouth, Edentulous / Q000150:complications / Q000534:rehabilitation*; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods; D010347:Patient Care Planning; D010349:Patient Compliance; D011111:Polymyalgia Rheumatica / Q000150:complications* / Q000188:drug therapy; D011476:Prosthodontics / Q000379:methods; D014081:Tooth Extraction; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids