What are the complications of an edentulous (without teeth) male with corner of lip atrophy and angular cheilitis (cracking)?

From the Guidelines

The patient is likely experiencing angular cheilitis, a common condition in edentulous individuals, and treatment should begin with topical antifungal cream such as clotrimazole 1% or miconazole 2% applied to the corners of the mouth 3-4 times daily for 7-14 days. This condition occurs because the decreased vertical dimension from missing teeth causes saliva to pool at the corners of the mouth, creating a moist environment ideal for fungal and bacterial growth 1.

Causes and Risk Factors

• The patient's edentulous state and corner of lip atrophy, cracking are likely contributing factors to the development of angular cheilitis
• Ill-fitting dentures can exacerbate this problem by causing saliva to pool at the corners of the mouth
• Nutritional deficiencies, particularly B vitamins, iron, and zinc, should also be assessed as they can contribute to angular cheilitis

Treatment and Prevention

• Topical antifungal cream such as clotrimazole 1% or miconazole 2% applied to the corners of the mouth 3-4 times daily for 7-14 days
• Combination products containing both antifungal and antibacterial agents like Mycostatin-Neosporin ointment may be more effective for more severe cases with bacterial involvement
• The patient should also apply petroleum jelly or zinc oxide ointment as a barrier protection after the antifungal treatment
• Maintaining good oral hygiene, keeping dentures clean, and removing them at night can help prevent recurrence
• The patient should be evaluated for proper denture fit and may need denture adjustments or replacements to address the underlying anatomical cause, which may involve the use of tilted implants or other treatment alternatives for the rehabilitation of the posterior edentulous maxilla 1

From the Research

Complications of Edentulous Patients

• Edentulism is a worldwide phenomenon that occurs due to biologic disease processes, such as dental caries, periodontal diseases, trauma, and oral cancer 2.
• Edentulous patients are at risk of several comorbidities that can significantly influence their overall health.

Atrophy of the Mandible

• The atrophy of the mandible can lead to various complications, including fractures, which can be challenging to manage due to poor bone quality and reduced contact area between the fracture ends 3, 4.
• The degree of atrophy can be classified into different classes, with Class III being the most severe, and is associated with a higher incidence of complications in fracture healing 4.

Corner of Lip Atrophy and Cracking

• There is limited information available on the specific topic of corner of lip atrophy and cracking in edentulous patients.
• However, it can be inferred that the loss of dentition and subsequent atrophy of the jawbone can lead to changes in the facial structure, including the lips, which may result in atrophy and cracking 5.

Treatment and Management

• The management of edentulous patients requires a multidisciplinary approach, including complete dentures, implant-retained and implant-supported prosthesis, and advanced technology 2.
• The treatment of fractures in edentulous patients with atrophic mandibles involves surgical management, including open reduction and internal fixation, and may require the use of compression plating or other fixation techniques 3, 4.
• In some cases, the use of antifungal agents, such as nystatin, may be necessary to treat oral candidiasis, which can be a common complication in edentulous patients 6.