J Adv Prosthodont.  2011 Mar;3(1):37-42. 10.4047/jap.2011.3.1.37.

An innovative prostheses design for rehabilitation of severely mutilated dentition: a case report

• Abduo J

• KMID: 1975113
• DOI: http://doi.org/10.4047/jap.2011.3.1.37

Abstract

Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with crown lengthening surgery and strategic implant placement. Series of provisional prostheses were applied to facilitate the transition to the final treatment.

Keyword

Diagnostic wax-up; Strategic implant; Provisional prosthesis; Telescopic attachment; Precision prosthesis

MeSH Terms

Crown Lengthening
Dental Occlusion
Esthetics
Humans
Prostheses and Implants
Prosthodontics
Tooth
Vertical Dimension

Figure

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  Fig. 1 Initial intraoral images. A: Frontal view of the dentition in occlusion, B: Frontal view of the dentition while the mandible is at rest, C: Right lateral view, D: Left lateral view.

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  Fig. 2 A: Articulated study models in centric relation, B: Diagnostic wax-up after restoring the VDO and simulated crown lengthening surgery.

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  Fig. 3 Panoramic radiograph demonstrating the location of the maxillary and mandibular implants.

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  Fig. 4 Frontal view of the first phase of rehabilitation.

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  Fig. 5 A: The fitting surface of the maxillary cross-arch provisional prosthesis revealing the acrylic resin margins and fitting surfaces, B: Frontal view after fitting the definitive mandibular prosthesis and the provisional maxillary prosthesis.

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  Fig. 6 Occlusal view of the maxillary definitive fixed prosthesis. The palatal milled surfaces, the extracoronal precision attachment and the telescopic primary copings exhibit a common path of insertion.

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  Fig. 7 A: The assembly of the telescopic attachment is composed of primary coping, the housing segment of the RPD framework and the electroformed secondary coping in between, B: The completed definitive RPD.

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  Fig. 8 A: Frontal view of the completed treatment after 2 months of prostheses delivery, B: Right lateral view, C: Left lateral view, D: Occlusal view.

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