Combined application of roll flap and combination onlay-interpositional graft to enhance esthetics of maxillary anterior fixed partial denture: A case report

In the maxillary anterior region, reconstruction of the localized alveolar ridge defect is very important in enhancing the esthetics of fixed partial denture. A 40-year-old female patient presented with a chief complaint of the inconvenience and unesthetic problem of 3-unit maxillary anterior prosthesis due to alveolar ridge resorption. After removal of old prosthesis, intraoral examination revealed moderate (buccolingually 4 mm) ridge deficiency in missing tooth region, leading to the diagnosis of Class I alveolar ridge defect. One of the reconstruction techniques to overcome this problem might be a technique that combines two types of soft tissue augmentation techniques. The purpose of this paper was to demonstrate the new combined technique of roll flap and combination onlay-interpositional graft utilized to acquire sufficient dimension of recipient area by one time of operation and to present the esthetic improvement of fixed partial denture by using this procedure in case of maxillary anterior localized ridge defect.     

Multidisciplinary approach to restoring anterior maxillary partial edentulous area using an IPS Empress 2 fixed partial denture: a clinical report

Esthetics is a major concern during restoration of anterior partial edentulous areas. All-ceramic fixed partial dentures may provide better esthetics and biocompatibility in the restoration of anterior teeth. This clinic report describes a multidisciplinary approach and treatment procedures with an IPS Empress 2 fixed partial denture to restore missing anterior teeth.     

Light-activated composite resin as an adjunct to the fabrication of fixed partial denture prosthesis

A technique that permits characterization of provisional restorations with bonding procedures is described. On completion, a glaze of unfilled resin is added to ensure a smooth, nonporous, biologically compatible restoration. Shade tabs are custom stained for dental laboratory use.     

Over-refractory casting technique as an alternative to one-piece multi-unit fixed partial denture frameworks

STATEMENT OF PROBLEM: Soldering has been suggested to achieve acceptable fit of multi-unit fixed partial denture (FPD) frameworks of 3 or more elements. However, distortion of the entire framework may occur. PURPOSE: The purpose of this study was to evaluate marginal fit in 1-piece-casting FPD frameworks comparing 2 casting techniques: the conventional technique (CT) and the over-refractory technique (ORT). The techniques were evaluated on castings made from commercially pure titanium (CP Ti; Tritan), titanium-aluminum-vanadium (Ti-6Al-4V), and nickel-chromium (Ni-Cr; VeraBond II) alloys. MATERIAL AND METHODS: A metal master cast including 3 preparations was created to simulate a 5-unit FPD. The metal cast was duplicated in vinyl polysiloxane for fabrication of 60 working casts. For the CT, 0.7-mm-thick patterns were waxed on the casts using an electrical wax-dipping unit. Patterns were removed from the preparations before investing. For the ORT, the silicone impressions were poured with an investment material (Rematitan for CP Ti and Ti-6Al-4V, and Talladium for Ni-Cr). The patterns were waxed on the refractory casts, and the assembly was invested. Both CT and ORT (n = 10), CP Ti, and Ti-6Al-4V frameworks were cast using an arc-melting titanium vacuum-casting machine. The Ni-Cr frameworks were cast using an automated centrifugal-casting machine. The mean marginal discrepancies of the frameworks were measured at the mesial, distal, buccal, and lingual interfaces. Marginal gap measurements were recorded 3 times for each surface to the nearest 0.5 microm using a traveling microscope (x50). The data were analyzed with 2-way analysis of variance, followed by the Tukey HSD test (alpha=.05). RESULTS: Marginal discrepancies for the ORT specimens (82.8 +/- 1.7 microm for CP Ti; 64.4 +/- 1.3 microm for Ti-6Al-4V; and 77.2 +/- 1.5 microm for Ni-Cr) were significantly lower than those obtained for the CT specimens (106.3 +/- 2.6 microm for CP Ti; 75.7 +/- 0.8 microm for Ti-6Al-4V; 101.9 +/- 1.7 microm for Ni-Cr) (P < .05). For both techniques, marginal discrepancies were significantly different among the alloys evaluated, presenting the following order from greatest to least marginal discrepancy: CP Ti, Ni-Cr alloy, and Ti-6Al-4V (P < .05). CONCLUSION: The ORT for multi-unit FPD frameworks demonstrated significantly lower marginal discrepancies than the CT.     

Restoration of maxillary anterior esthetics using lava all-ceramic fixed dental prostheses

The success of all-ceramic crowns and increased patient demand for metal-free, tooth-colored restorations has led to the development of many different restorative systems for all-ceramic fixed dental prostheses (FDPs). The most recent core materials for all-ceramic FDPs are the yttrium-tetragonal zirconia polycrystal (Y-TZP)-based materials. Yttrium oxide is a stabilizing oxide added to pure zirconia to stabilize it at room temperature and to generate a multiphase material known as partially stabilized zirconia. This exhibits very high flexural strength and fracture toughness along with good biocompatibility and excellent esthetics. This clinical report describes the use of the Lava All-ceramic system, based on Y-TZP, for the fabrication of two fixed dental prostheses (FDPs) in the maxillary anterior region of the patient, restoring both esthetics and function.     

Distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis: a clinical report

This clinical report demonstrates the possibility of achieving positive results with a removable prosthesis connected to an implant-supported fixed prosthesis. Bone quality and quantity at the implant sites are essential requirements for the success of the treatment. The support of the RPD and its connection with the fixed prosthesis creates stability during chewing activity and allows a functional activity similar to that involving an overdenture. The adoption of an occlusal scheme with subocclusion of the fixed prosthesis contacts compared with those of the removable prosthesis, together with the stress-director system of the RPD can be effective factors that decrease the risk of loss of implant integration. Further long-term follow-up studies with a larger patient population are needed to confirm the clinical and biomechanical validity of the prosthetic solution described in this clinical report.     

Anterior maxillary resin-bonded fixed partial denture to preserve occlusal surface area for anterior guidance. A clinical report

One of the problems with anterior maxillary resin-bonded fixed partial dentures is anterior-guided occlusion. An anterior maxillary resin-bonded fixed partial denture was fabricated. The reduction of the lingual surface of the abutment was restricted to the nonocclusal surface area for anterior guidance. The patient's original mandibular movement did not change after the denture was seated. The denture has been functioning satisfactorily without any problems for more than 72 months. This article emphasizes the concept of fabricating an anterior maxillary resin-bonded fixed partial denture without reduction of the occlusal surface area for anterior guidance.     

Esthetic removable partial denture design in replacing maxillary anterior teeth

Prosthodontic rehabilitation of missing maxillary anterior teeth requires special consideration to restore function and esthetics. This case report describes the prosthodontic management of a patient who lost three maxillary incisors due to a motor vehicle accident. A rotational path removable partial denture was constructed, for which a proximal undercut was created by means of a composite buildup to provide the retention for the prosthesis.     

The swing-lock partial denture: an alternative approach to conventional removable partial denture service.

There are many common problems associated with the use of conventional clasp removable partial dentures. An alternative modality in many instances is the swing-lock removable partial denture. Its advantages, disadvantages, indications, and contraindications are discussed. The procedures of fabrication, placement, and adjustments are described.     

A nine-year clinical case study of a resin-bonded fixed partial denture seated on the maxillary anterior teeth

PatientThis report describes the longevity of a resin-bonded fixed partial denture (RBFPD). This denture was seated on the maxillary anterior teeth with minimal tooth preparation. The RBFPD was cast from a silver–palladium alloy (Castwell M.C. 12), and the pontic was veneered with an indirect composite material (Estenia). The retainers were primed with a metal conditioner (V-Primer) and seated with a tri-n-butylborane initiated adhesive resin (Super-Bond C&B). After an observation period of eight years, a fracture occurred in the incisal edge of the central incisor abutment. The fractured area was restored with light-polymerizing composite resin and the anterior guidance was re-adjusted.DiscussionRBFPD abutment teeth with deep vertical overlap should be carefully prepared to avoid abutment tooth fracture.ConclusionThe clinical performance of the RBFPD made from a silver–palladium–copper–gold alloy was sufficient when seated with tri-n-butylborane initiated adhesive resin after surface modification using vinyl-thiol primer.Clinical significanceThe use of vinyl-thiol primer and tri-n-butylborane initiated adhesive resin is a clinically reliable bonding system for seating resin-bonded fixed partial denture (RBFPD) made from a silver–palladium–copper–gold alloy. The RBFPD, based on a reliable bonding system, can clinically function for a long time, even if the vertical overlap of the abutment teeth is excessive.     

Achieving optimal esthetics in a patient with severe trauma: using a multidisciplinary approach and an all-ceramic fixed partial denture

The treatment of traumatic injuries can be difficult, especially when the patient's expectations are too high or unreasonable. Such cases require extremely clear communication with the patient before beginning the case, including an explanation of the final results, based on the patient's goals. Taking over a case from another colleague adds more complications and requires that close attention is paid to the reason for the original dissatisfaction between the former dentist and patient to avoid repeating the same mistakes. Clinically, patients with thin, fragile gingiva are extremely challenging if they require a fixed partial denture in the esthetic zone since the most common material, a ceramometal bridge, requires infragingival margins; if any recession occurs, a catastrophic esthetic failure will result. The case presented here underscores all these special issues. Proper multidisciplinary management, good patient communication, and the use of an all-ceramic fixed partial denture system can provide an excellent final result.     

Application of various removable partial denture design concepts to a maxillary obturator prosthesis.

A patient with a relatively minor yet common acquired maxillary defect was provided with three obturators of differing design. His subjective evaluations and the relative merits of the designs were discussed.     

可摘式美学牙龈修复体在上颌前份种植义齿中的应用

目的 介绍一种改善上颌前份种植义齿美学效果的新方法。方法 54例上颌前牙缺失的患者接受了种植义齿修复后，其中的8例患者存在有基台外露，义齿牙冠过长和牙间楔状间隙显著等影响美观的临床表现，作者利用丙烯酸树脂制作精确吸附固位的可摘式人工牙龈修复体来恢复种植义齿的牙冠及牙周组织的解剖学形态。结果 经过2年的随访观察，未见牙龈退缩与种植体周围炎的发生，人工牙龈修复体理想地纠正了上述患者种植义齿的美学缺陷。结论 本方法简单，经济，实用，可有效地增强上颌前份种植义齿修复后的美学与功能。     

���ǰ����������ѧ�о���չ

提要：上颌前牙区美学修复是口腔医学的重要组成部分。多数学者一直致力于牙体排列、大小、颜色等方面的研究,而对于牙龈美学的研究相对较少。牙龈美学作为微笑美学不可或缺的部分,也越来越受到医生和患者的重视。如何构建更为协调、美观的微笑,这使得学者们不得不共同关注牙齿、牙龈、口唇三者之间的美学参数。本文就上颌前牙区牙龈美学相关参数做一综述。     

Tissue sculpturing: an alternative method for improving esthetics of anterior fixed prosthodontics

Esthetics associated with health of surrounding tissues in fixed prosthodontics is arduous, especially when treating the maxillary anterior region. An unfavorable relationship between residual ridge, pontic, and gingival papilla commonly compromises the final result. Alternative procedures based on biologic procedures can be developed to improve relationships and provide esthetic and functionally acceptable fixed partial dentures. This article describes a technique for the improvement of esthetics with conditioning of the tissue beneath the pontics, by displacing tissue with a treatment restoration. Lateral displacement of tissue under gradual, controlled pressure enhances the interdental papilla, which improves esthetics. The role of plaque control is also discussed in this article.