Prosthodontic Rehabilitation of a Patient With Psoriasis and Severe Medication-Related Nausea Using Telescopic Crown-Retained Removable Prostheses: A Clinical Report
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
The rehabilitation of partially edentulous patients with complex medical history presents substantial clinical challenges, particularly when both implant-supported and conventional removable prosthetic options are limited. This case report describes the comprehensive management of a 67-year-old female patient referred for prosthetic rehabilitation of a severely compromised dentition. The patient expressed a strong preference for implant-supported restorations; however, due to her autoimmune condition (psoriasis) and ongoing methotrexate therapy, implant placement was contraindicated. Additionally, persistent vomiting and severe nausea significantly complicated the clinical procedure. A patient-centered and interdisciplinary approach was adopted. In collaboration with the patient’s physician, methotrexate was temporarily discontinued to improve tolerance to dental treatment. Following extractions of non-restorable teeth, a telescopic crown-retained removable complete denture (RCD) was selected as the definitive treatment plan for both dental arches. Digital workflows were implemented with intraoral scanning, and both the mandibular and maxillary arches were restored. At 18-month follow-up, the patient demonstrated excellent functional and aesthetic outcomes, with complete resolution of nausea symptoms during prosthesis use. This case highlights the importance of individualized treatment planning, digital prosthodontic workflows, and the advantages of telescopic systems in mana
Abstract
The rehabilitation of partially edentulous patients with complex medical history presents substantial clinical challenges, particularly when both implant-supported and conventional removable prosthetic options are limited. This case report describes the comprehensive management of a 67-year-old female patient referred for prosthetic rehabilitation of a severely compromised dentition. The patient expressed a strong preference for implant-supported restorations; however, due to her autoimmune condition (psoriasis) and ongoing methotrexate therapy, implant placement was contraindicated. Additionally, persistent vomiting and severe nausea significantly complicated the clinical procedure. A patient-centered and interdisciplinary approach was adopted. In collaboration with the patient’s physician, methotrexate was temporarily discontinued to improve tolerance to dental treatment. Following extractions of non-restorable teeth, a telescopic crown-retained removable complete denture (RCD) was selected as the definitive treatment plan for both dental arches. Digital workflows were implemented with intraoral scanning, and both the mandibular and maxillary arches were restored. At 18-month follow-up, the patient demonstrated excellent functional and aesthetic outcomes, with complete resolution of nausea symptoms during prosthesis use. This case highlights the importance of individualized treatment planning, digital prosthodontic workflows, and the advantages of telescopic systems in managing medically compromised patients with high aesthetic demands and functional limitations.