J Korean Acad Prosthodont.  2013 Oct;51(4):323-331. 10.4047/jkap.2013.51.4.323.

Pontic site development and soft tissue transfer of the esthetic area: a case report

• Kim HC
• Noh K
• Kwon KR
• Kim HS

• KMID: 2000157
• DOI: http://doi.org/10.4047/jkap.2013.51.4.323

Abstract

Soft tissue collapse around prepared teeth and pontic is inevitable after removal of the provisional restoration during the impression taking procedures. When inserting gingival retraction cord, soft tissue is displaced to an undesired contour. Viscosity of impression material also causes gingival displacement. Therefore, the consideration to transfer the prosthetically contoured soft tissue to master cast is required, especially in the esthetic area. In this report, the methods to maintain the soft tissue contour and transfer to the mastercast will be introduced. Harmonious contour of the soft tissue can be achieved with provisional restoration and be transferred to the master cast with two different techniques mentioned in this case report.

Keyword

Soft tissue cast; Pontic; Residual ridge; Provisional restoration

MeSH Terms

Denture, Partial, Fixed*
Tooth
Viscosity

Figure

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  Fig. 1. A: Frontal view before treatment, B: Periapical view before treatment.

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  Fig. 2. CT view before treatment. A: Coronal view, B: Transverse view.

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  Fig. 3. Extraction of supernumerary tooth and ridge augmentation.

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  Fig. 4. Initial view of gingival contour. A: Frontal view, B: Occlusal view, C: provisional restoration.

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  Fig. 5. Two months after gingival sculpturing. A: Frontal view, B: Occlusal view, C: Provisional restoration.

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  Fig. 6. Procedure of soft tissue replication. A: Provisional restoration in position without provisional cement, B: Pick-up impression of the provisional restoration, C: Inject regular-body vinyl polysiloxane impression material, D: Silicone cast, E: Adapt the zirconia coping on the silicone cast. Place pattern resin with bead-brush technique, F: Place customized zirconia coping over the abutment teeth, G: Make definitive transfer impression using heavy- and light-body vinyl polysiloxane, H: Pour the impression with soft tissue cast material, I: Place customized zirconia coping on soft tissue cast, J: Mounting on articulator with customized anterior guide table.

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  Fig. 7. A: Intraoral view of the final prosthesis, B: Final prosthesis, C: Two months after gingival sculpturing, D: Provisional restoration.

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  Fig. 8. A: Frontal view before treatment, B: Periapical view before treatment.

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  Fig. 9. Diagnostic wax-up.

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  Fig. 10. A, B: Immediate after extraction, C, D: Two months after gingival sculpturing.

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  Fig. 11. Procedure of soft tissue replication. A, B, C: Provisional restoration in position without provisional cement with bead-brush technique, place pattern resin on soft tissue around provisional restoration, D: Place provisional restoration with pattern resin dam on definitive cast, E: Inject light-body polyvinylsiloxane impression material, F: soft tissue cast, G: Mounting on articulator with customized anterior guide table.

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  Fig. 12. A: Intraoral view of the final prosthesis, B: Final prosthesis, C: Two months after gingival sculpturing, D: Provisional restoration.

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