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Table of Contents
CASE REPORT
Year : 2022  |  Volume : 6  |  Issue : 3  |  Page : 152-155

Cheek plumper: An instant, noninvasive face-lifting prosthesis—A case report


Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, India

Date of Submission22-Jun-2022
Date of Decision07-Aug-2022
Date of Acceptance27-Aug-2022
Date of Web Publication15-Nov-2022

Correspondence Address:
Ahila Singaravel Chidembaranathan
Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/SDJ.SDJ_33_22

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  Abstract 

Background: Restoring lost form and function in edentulous patients is a challenge when the edentulous state has remained in a long term. Most patients with chronic edentulism suffer from a range of problems, such as reduction in facial height, cheek muscle wastage, and tongue spreading. These problems lead to an esthetic imbalance in the facial appearance. Many patients remain unsatisfied after fitting complete dentures, as these do not resolve the issue of sunken cheek appearance. Case Report: A 70-year-old male patient presented with the chief complaint of missing dentition. He also complained of the sunken cheeks. After restoration with conventional dentures, the patient still complained of sunken cheeks. This complaint was addressed by fabricating cheek plumper, and the cheek plumper was attached with the buccal flange of the maxillary denture utilizing intraoral neodymium magnets. Conclusion: Treating cases of the complete edentulism requires not only denture but also restoring the facial esthetic appearance by addressing muscle wastage. Cheek plumper is a simple, yet effective way to restore the facial contour.

Keywords: Cheek plumper, complete denture, esthetics, magnets, prosthesis


How to cite this article:
Chandrasekar V, Singaravel Chidembaranathan A, Muthukumar B. Cheek plumper: An instant, noninvasive face-lifting prosthesis—A case report. Sci Dent J 2022;6:152-5

How to cite this URL:
Chandrasekar V, Singaravel Chidembaranathan A, Muthukumar B. Cheek plumper: An instant, noninvasive face-lifting prosthesis—A case report. Sci Dent J [serial online] 2022 [cited 2022 Dec 3];6:152-5. Available from: https://www.scidentj.com/text.asp?2022/6/3/152/361155




  Background Top


Adequate dentition is required for normal digestive system function. The importance of dentition is often realized only when teeth have been lost. Edentulism refers to a partial or complete loss of teeth, which can lead to difficulties with speech and mastication.[1] The treatment modalities for the complete loss of teeth include conventional complete dentures to implant-retained prostheses.[2] Despite meticulous replacement of missing teeth, some patients complain of an unsatisfactory facial appearance after dentures have been fitted. This complaint can be attributed to the importance placed on facial esthetics today. Thus, simply restoring missing teeth may not be sufficient, as edentulous patients today expect the reestablishment of lost facial contours.[3]

Completely edentulous patients are prone to a decrease in buccal fat volume and buccinator muscle wastage, primarily because of a decrease in the vertical facial height for a prolonged period due to a loss of teeth.[4],[5] The latter results in concavities beneath the malar bone, ultimately leading to a hollow or sunken cheek appearance, which makes patients look older than their actual ages.[5],[6]

The addition of a cheek plumper to dentures is a simple way of rectifying sunken cheeks. The plumper is attached to the buccal flanges of the denture using different modes of retention, such as metallic snaps, customized attachments, or friction locks.[7] Cheek plumpers, which tend to give a fuller and healthier appearance, are a simple way of restoring a hollowed-out facial contour, without any invasive procedures. In this case report, cheek plumpers retained using intraoral neodymium magnets were utilized to enhance the facial appearance of a patient who was self-conscious about a hollowed-out cheek appearance after fitting conventional complete dentures.


  Case Report Top


A 70-year-old male patient reported to the Department of Prosthodontics at SRM Dental College, Ramapuram, Chennai, with the chief complaint of missing upper and lower front and back teeth. He also complained of a hollowed-out facial appearance. On intraoral examination, the patient was completely edentulous. The patient reported a history of tooth loss due to periodontal disease and dental caries. Further probing revealed that the patient was edentulous for about 2–3 years. An extraoral examination showed an accentuated nasolabial fold, drooping lips, and a hollowed-out buccal region. Preliminary diagnostic procedures, including radiographs, were performed, and impressions were made. Preoperative photographs were taken to assess the hollowed-out appearance. The patient was advised about anatomical age-related changes. To improve his facial appearance, treatment modalities, including grafting into the zygomatic bone and cheek plumpers, were proposed. As grafting procedures are invasive, the patient selected a noninvasive cheek plumper prosthesis to improve his facial esthetics.

Dentures were fabricated conventionally using heat-cured acrylic resin (DPI Heat Cure, Rudrapur, Uttarakhand, India). The dentures were inserted, followed by finishing and polishing [Figure 1]. The cheek plumpers were retained by neodymium-iron-boron magnets, which are more retentive than cobalt-chromium samarium magnets.[8] In this case report, 3-mm diameter and 1.5-mm thick rust-free neodymium-iron-boron magnets (Ambika Corporation, New Delhi, India) were used [Figure 2].
Figure 1: Edentulous maxilla and mandible

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Figure 2: Intraoral magnets

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The dentures were inserted into the patient’s mouth. The wax patterns for the cheek plumpers were extended distally from the first premolar until the mesial surface of the second molar similar to buccal corridor [Figure 3]. Once the patient was comfortable and satisfied with his appearance, the wax pattern was processed using heat-cured acrylic resin by compression molding method; then the cheek plumpers were finished and polished. Intraoral magnets were then installed along the buccal flanges of the denture in the corresponding positions in the cheek plumper using autopolymerizing resin [Figure 4]. Finally, the dentures, along with the magnetically retained cheek plumpers, were inserted into the oral cavity and checked for retention of the denture [Figure 5]. The patient was instructed to remove the cheek plumpers while eating, as they might hinder mastication.
Figure 3: Wax pattern of the cheek plumper

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Figure 4: Magnets attached to the buccal flange of the denture

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Figure 5: Cheek plumper attached to the denture

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The patient was re-called after 24 h, 1 week, 1 month, and 6 months for review appointments. The patient reported no difficulties while wearing the dentures along with cheek plumpers. The patient’s facial appearance improved markedly [Figure 6]A and B.
Figure 6: A, Frontal view before denture insertion; B, frontal view after denture and cheek plumper insertion

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  Discussion Top


Although aging is a natural process, aging-related changes in the facial region can lead to a decrease in self-confidence. Esthetic expectations of geriatric patients have increased over the years.[9] Treating completely edentulous patients is a challenge, as the complete restoration of the anatomy that was lost is required.[10] Young suggested that dentists must take account of esthetic and functional values while treating edentulous patients.[4] A classic tell-tale sign of aging is slumped or hollowed-out cheeks due to extensive muscle wastage. Cheek plumpers provide a simple, noninvasive, yet effective treatment modality to combat this undesirable effect of aging.

There are several retention methods for the retention of cheek plumper. Magnets are superior method of retention, as they do not hinder with cheek or cause irritation to the patient. Maintaining oral hygiene and reorienting the cheek plumper are relatively simple. Rare earth elements, such as neodymium, are resistant to corrosion.[11] Rare earth magnets have extremely high magnetic saturation and good resistance to demagnetization. These properties of rare earth magnets allow the production of magnets with very small dimensions.[12] In addition, the production cost of rare earth magnets is comparatively lower than that of samarium-cobalt alloys. Hence, the popularity of rare earth magnets has increased in dentistry.

Dentures with thicker buccal flanges is an attempt to create fullness in the cheek area can cause muscle fatigue and discomfort after continued usage. Dentures with detachable magnetically retained cheek plumpers allow the patient to use the prosthesis when required, without having to experience any discomfort.


  Conclusions Top


Geriatric patients undergoing the treatment for complete dentures require special care to address issues relating to muscle wastage including sunken cheeks. Providing simple interventions, such as cheek plumpers, can be of great help in improving the overall facial appearance and self-confidence of older individuals, allowing them to socialize with confidence posttreatment.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Martone AL Effects of complete dentures on facial esthetics. J Prosthet Dent 1964;14:231-55.  Back to cited text no. 1
    
2.
Tautin FS Denture esthetics is more than tooth selection. J Prosthet Dent 1978;40:127-30.  Back to cited text no. 2
    
3.
Lombardi RE The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973;29:358-82.  Back to cited text no. 3
    
4.
Young HA Denture esthetics. J Prosthet Dent 1956;6:748-55.  Back to cited text no. 4
    
5.
Larzen SJ, Carten JF, Abrahamian HA Prosthetic support for unilateral facial paralysis. J Prosthet Dent 1976;35:192-201.  Back to cited text no. 5
    
6.
Mukohyama H, Kadota C, Ohyama T, Taniguchi H Lip plumper prosthesis for a patient with a marginal mandibulectomy: A clinical report. J Prosthet Dent 2004;92:23-6.  Back to cited text no. 6
    
7.
Riley MA, Walmsley AD, Harris IR Magnets in prosthetic dentistry. J Prosthet Dent 2001;86:137-42.  Back to cited text no. 7
    
8.
Javid N The use of magnets in a maxillofacial prosthesis. J Prosthet Dent 1971;25:334-41.  Back to cited text no. 8
    
9.
Clair F Picard complete denture esthetics. J Prosthet Dent 1958;8:252-9.  Back to cited text no. 9
    
10.
Waliszewski M Restoring dentate appearance: A literature review for modern complete denture esthetics. J Prosthet Dent 2005;93:386-94.  Back to cited text no. 10
    
11.
Sunil MV, Rao H, Sohi KS Artificial cheek plumper’s: A step ahead in denture esthetics—A case report. Indian J Stomatol 2011;2:134-7.  Back to cited text no. 11
    
12.
Bhat VS, Shenoy KK, Premkumar P Magnets in dentistry. Arch Med Health Sci 2013;1:73.  Back to cited text no. 12
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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