CHIEF COMPLAINT:
To replace a removal partial denture in tooth 21.
DIAGNOSIS:
Male patient, 55 years old, smoker. Presented to our dental appointment with a dental implant placed in the area of tooth #21. The gingival architecture in the area lack interdental papilla and showed a vertical deficiency of the soft tissue. Adjacent teeth had significant root exposure.
TEAM PLAY ‘DENTIST – DENTAL TECHNICIAN’ NOTES:
After a brainstorming with the Dental Technician, we have decided to initiate the laboratorial part of the rehabilitation pursuing the following objectives:
The prosthetic component over the dental implant should be, if possible, screwed, avoiding cement interfaces.
The prosthetic component should incorporate a ceramic part which mimics the crown and the roots of adjacent teeth, as well as the gingiva that is missing in the vertical deformity.
Following the observation of the working cast it was concluded that the angulation of the dental implant did not allow to do a screwed dental prosthesis. As so, an anatomical abutment was customized with crown margins placed 1mm infragingival, to allow the removal of the cement. The abutment had the desired emergency profile as well as a suitable polishing. These laboratory considerations were then tested in the mouth. They were all adequate. In this appointment, the dentist and the dental technician evaluate also the color of the crown, root and gingiva, by using appropriate color guides. The ceramist was then able to mimic all the missing soft and hard tissues with dental ceramics. Although unconventional, this rehabilitation was well accepted by the patient, easy to perform and proved to be aesthetically satisfying and stable over time.
DENTAL LABORATORY:
DentalMaia, Castelo da Maia, Portugal.