Management of Pathological Dental Attrition in Prader–Willi Syndrome: A Case Report Using the Personalized Radboud Strategy

Abstract

Prader–Willi syndrome (PWS) is a rare genetic disorder characterized by obesity, hypotonia, intellectual disability, and behavioral disturbances that complicate dental management. Parafunctional habits such as bruxism often lead to severe tooth wear, while cooperation and anesthesia represent additional challenges. A 34-year-old woman with genetically confirmed PWS presented with generalized dental wear, poor oral hygiene, and multiple carious lesions. Preventive and splint therapies were initially proposed but not feasible. Two years later, she returned with pain due to pulp exposure. Because of limited cooperation and comorbidities, dental treatment under general anesthesia was planned in two sessions, including molar extractions and multiple root canal treatments. Complete acrylic dentures with metal reinforcement were fabricated, restoring vertical dimension, improving esthetics, and serving as protective splints. Caregivers were instructed on hygiene, and annual follow-up was established. After six years, bone atrophy and further wear were noted, but the patient continued using relined prostheses without sedation. This case demonstrates that a resolutive, interdisciplinary approach can successfully manage complex dental problems in PWS. General anesthesia minimized the number of interventions while ensuring comprehensive care. Reinforced acrylic dentures provided a functional, aesthetic, and cost-effective solution, despite the progressive nature of dental wear and bone loss.