A simplified technique of fabricating foldable mandibular complete denture using a custom-made hinge assembly

There are several conditions that affect the extent of mouth opening in the general population, such as oral submucous fibrosis, scleroderma, radiation therapy or surgically induced microstomia.¹ Oral submucous fibrosis is a pre-cancerous condition in which palpable fibrotic bands are seen involving the buccal mucosa, floor of the mouth, lips and tongue that causes blanching and stiffening of the oral mucosa leading to trismus.² In particular, the prosthetic rehabilitation of such patients is further complicated by tongue rigidity, difficulty in chewing, swallowing and speaking. This results in unstable and non-retentive dentures causing pain, discomfort and an array of functional problems (Figure 1).

Many of these apparent clinical difficulties associated with restricted mouth opening can be overcome by sectional impression techniques and modified prosthesis designs such as sectional complete dentures using a Co-Cr framework with hinges or swing-lock attachments, commercially available magnetic attachment systems and flexible dentures.^3,4,5 McCord et al used a removable stainless steel post that inserted into three tubes within the complete denture palate to join the two halves of a sectional complete denture.⁶ Al-Hadi and Abbas incorporated acrylic resin connections in the form of a dovetail with special directions to orient and secure the sectioned mandibular complete denture.⁷ An alternative method is to use a foldable complete denture through fabrication of a custom-made hinge mechanism using an orthodontic bracket with a buccal tube and a 0.7 mm stainless steel wire.