Association of fixed partial denture and gingival prosthesis as alternative

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JPOR-150; No. of Pages 5

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Journal of Prosthodontic Research xxx (2012) xxx–xxx

Case report

Association of fixed partial denture and gingival prosthesis as alternative approach to recover esthetics and function in anterior maxillary region
Cristiane Okano Ajita DDSa, Rodolfo Bruniera Anchieta MSb,*,Manoel Martin Jr. PhDc, Carlos Marcelo Archangelo PhDc, Naiara Reis Gil DDSd, Carlos Alexandre Bertoncelo MSc, Daniela Garcia Nesello DDSa

Privative Dentist, Londrina, PR, Brazil Sao Paulo State University-UNESP, Faculty of Dentistry of Aracatuba, Department of Dental Materials and Prosthodontics, Aracatuba, SP, Brazil ¸ ¸ c Institute Federal of Parana, Prosthodontics, Londrina, PR, Brazil d ´ ˜Privative Dentist, Sao Jose do Rio Preto, SP, Brazil Received 13 September 2011; received in revised form 20 December 2011; accepted 3 February 2012


Abstract Tooth replacement in the maxillary anterior region is especially difficult when the loss includes significant amounts of the residual ridge and the soft tissue. Several techniques are available, such as dental implants or fixed partialdenture, and bone and gingival grafts or gingival prostheses, respectively. This article showed a clinical case of an elderly who was treated with a collarless metal–ceramic fixed partial denture and acrylic removable gingival prosthesis to recover the esthetics in the maxillary anterior region. The association of a metal–ceramic fixed denture and gingival prosthesis was an excellent alternative incases when surgical procedures are contraindicated. # 2012 Japan Prosthodontic Society. Published by Elsevier Ireland. All rights reserved.
Keywords: Metal–ceramic fixed partial denture; Gingival prosthesis; Prosthodontics

1. Introduction The area of soft tissue and teeth displayed when a patient smiles is often referred to as the esthetic zone and usually includes the teeth in the maxillaryarch anterior to the second premolar. Tooth replacement in this area presents challenges for the clinicians that are especially difficult when the loss includes significant amounts of the residual ridge and the accompanying soft tissue [1]. Other problem in the esthetic zone area is gingival recession or marginal tissue recession [2]. These is a condition that frequent happens in older populations [3],populations with a high standard of oral hygiene, and in periodontally untreated populations with poor oral hygiene [2]. Hard and soft tissue loss can result in enlarged increased

* Corresponding author at: Universidade Estadual Paulista-UNESP, Facul´ dade de Odontologia de Aracatuba, Departamento de Materiais Odontologicos e ¸ ´ ´ Protese, Rua Jose Bonifacio, 1193 Vila Mendonca, 16015-050Aracatuba, SP, ¸ ¸ Brazil. Tel.: +55 18 3636 3290; fax: +55 18 3636 3290. E-mail address: (R.B. Anchieta).

crown length, causing esthetic problems and hypersensitivity of root surfaces [4–6]. Selecting the best esthetic prosthetic treatment for teeth with gingival recession in the anterior region may be challenging [7,8]. In these situations, lip line, gingival line,and anatomic crown length are important factors for esthetic results, as well as a good lip support [5,9]. A high smile line can be an obstacle to achieving an esthetic outcome [5,9]. Although many surgical procedures have been proposed for augmentation of bone and soft tissue structures, predictable results may not be routinely achievable [10,11]. In addition, many patients are not responsive orhave systemic diseases, contraindicating invasive oral surgeries such as bone and soft tissues grafting [4,10–12]. For these patients, prosthetic replacement with acrylics, composite resins, porcelains, and silicones is a predictable approach to replacing lost tissue architecture [7,8]. The aim of this report was to show a clinical case of a collarless fixed partial denture (FPD) associated with a...
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