Fixed Implant-Supported Full-Arch Prosthesis in Epidermolysis Bullosa With Severe Symptoms

Oral maxilla restoration using complete fixed prosthetic in a 31-year-old patient diagnosed with severe RDEB. (a) Facial aspect with multiple abrasions and scars on the skin as a result of blisters and the retraction of tissues. (b) Intraoral aspect: limited oral aperture, initial acrylic prosthesis in poor condition, displaced and lacking support. Multiple carious lesions with notable deterioration of the dental tissues making impossible the restoration over the natural tooth. (c) Initial CAT showing severe alveolar bone resorption with atrophy of the maxilla and considerable deterioration of the remaining teeth. Note the blocked right sinus.

(d) Six implants inserted in the anterior region (premolar, canine, lateral/incisor) with good initial torque of over 40 N. (e) Pillars and metallic structures in passive position. Note the good adaption of the soft tissues and the even distribution. (f) Metal-ceramic maxilla restoration with an implant-supported full arch fixed prosthetic. (g) Radiological control 12 months following the insertion of the prosthesis.

(h) Facial aspect posttreatment. (i) Mandible intraoral aspect. Multiple carious lesions with notable deterioration of the dental tissues making impossible the restoration over the natural tooth. (j) Five implants inserted in the anterior region (between pre-molars) with good initial torque of over 40 N. (k) Panoramic radiograph after mandibular implant placement. Maxillary prosthesis can be observed. (l) Maxillary implants follow-up. Healthy mucosa after removing the prosthesis. (m) Facial aspect after mandible treatment.