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A technique is presented for the fabrication of an esthetic, provisional fixed partial denture that compensates for a pontic-site ridge defect. This provisional restoration enables both the dentist and the patient to evaluate whether this prosthetic approach will adequately camouflage the pontic-site defect or whether surgical correction of the pontic site should also be considered.
Bridges at least with two types of retainers (adhesive frame-work, inlay, onlay, overlay, or crown) might be called fixed partial dentures with combined retainers. The aim of the present study was to compare the fixed partial dentures with combined retainers made at our clinic between 1986 and 1996. In our study the cumulative proportional survival of the combined bridges was found 80%. Examining the loss of the combined bridges it seems that in the first year 1% of the bridges came off. The rest was lost between 12th and 48th months.
Five Veterans Administration centers have participated in a study to determine whether fixed partial dentures (FPDs) supported by blade implants offer an acceptable substitute for mandibular unilateral or bilateral distal-base extension removable partial dentures (RPDs). The study design and methodology have been described in Part I. A total of 232 patients received comprehensive dental care including RPDs for 118 patients and FPDs for 114. Prespecified criteria determined treatment failures. During the 60-month period, treatment failures occurred in 19 FPD patients and 30 RPD patients. Ten FPD failures occurred before and nine after the FPD insertion. Five RPD failures were caused by abutment tooth loss and 25 for not using the RPD while eating. Life table analysis showed 5-year success rates of 84.2% for the FPD and 74% for the RPD. The 17.9% higher FPD success rate in Kennedy class II patients was both statistically and clinically significant. Excluding the 10 early failures, the 5-year FPD success rate was 91.5%. Of the 170 attempted implants, 26 failed, including 12 before the FPD fabrication. Radiographic assessments by a panel of three judges showed no bone deterioration during baseline to 60 months in 29.6%, slight in 25.4%, moderate in 15.9%, marked in 27%, and severe deterioration in 2.1% of the implant posts.
Five Veterans Administration Medical Centers participated in a study to determine the comparative influence of fixed partial dentures (FDPs) supported by endosteal blade implants and removable partial dentures (RPDs) on masticatory performance. The study design, methodology, and success rates have been described in Parts I and II. A total of 232 patients received comprehensive dental care, including RPDs for 118 patients and FPDs for 114. Three standardized masticatory tests were made with peanuts and carrots before treatment. These tests were repeated at 16 weeks following RPD or implant insertion and thereafter at 6, 18, 36, and 60 months. At entry, there were no significant differences in performance scores and chewing time and strokes taken to reach the swallowing threshold between the RPD and FPD groups (p greater than 0.05). After treatment completion, FPDs and RPDs significantly improved the masticatory ability of patients with Kennedy class I or class II edentulous conditions (p less than 0.001). The improvements in performance scores for both test foods were slightly better in the RPD group than in the FPD group, although none of the 30 mean differences was significant (p greater than 0.05). After the baseline period to 60 months, only slight changes in performance scores were observed for both groups. RPDs and FPDs were comparable in improving the chewing efficiency of patients with Kennedy class I and class II partially edentulous conditions.
This article describes a procedure for fabricating an optimal provisional restoration before tooth preparation. The procedure involves the fabrication of an indirect-direct provisional fixed partial denture. There are several advantages to this procedure, such as reduced chair time, less heat generated in the mouth, reduced contact between resin monomer and soft tissues, and optimal esthetics.
This article describes the modification of a procedure for fabricating a laboratory-processed, metal-reinforced, acrylic resin provisional restoration that becomes an implant-retained fixed partial denture. The modification involves the incorporation of patrix and matrix components into a cast metal framework. The prosthesis can be used as an alternative to a removable radiologic stent and surgical guide. It can function as a surgical guide during implant placement and help retract the buccal mucogingival flap during implant placement. The prosthesis also can be used as an aid in locating the implant during stage II surgery. Finally, the pontics can be converted into an implant-supported provisional restoration immediately after the implant prosthetic components are attached to the uncovered implants.
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The resin-bonded fixed partial denture is a conservative option for the replacement of a missing tooth. It has a good prognosis and offers several advantages over a conventional fixed partial denture. However, it does not allow for placement of a provisional fixed partial denture. In some situations, it is important to provide some type of interim treatment. This can be accomplished by several techniques, that include placement of either a removable or bonded replacement tooth. The provisional treatment can provide an esthetic solution and maintain tooth position while the fixed partial denture is being made by the dental laboratory.
Provisional restorations are generally necessary to restore lost function and esthetics during the implant integration period. This article describes the fabrication of an esthetic, economic, and conservative bonded provisional fixed partial denture for a patient restored with implants. A reinforcing polyethylene ribbon was used to bond the natural lateral incisors to the adjacent teeth. An acceptable esthetic outcome was obtained, and the result was satisfactory to the patient.
The success of a dental prosthesis is judged according to function, comfort, phonetics, and esthetics. The purpose of a treatment is to come as close as possible to replicating the natural state. For anterior fixed partial dentures, the all-ceramic system IPS Empress 2 offers light transmission and reflection comparable to that of natural teeth, provided that the pink esthetics are optimized in the preprosthetic treatment phase. In this case report, a laboratory-made provisional was placed after extraction of an anterior tooth. Six months later, preprosthetic periodontal surgery was carried out to enhance gingival harmony. The design of the post and core, preparation, and cementation are important parameters for the success of all-ceramic restorations.
The development of fiber-reinforced composites offers new possibilities in minimally invasive tooth replacement approaches. This article describes the use of a prefabricated fiber-reinforced composite resin framework for the chairside fabrication of a provisional fixed partial denture over an integrating implant. The framework fabrication, theory, and a clinical scenario are illustrated.
STATEMENT OF PROBLEM: Provisional prostheses are subject to flexure under function. Selection of the appropriate material for their fabrication is difficult given the limited evidence-based information on the flexural strength of provisional resins. PURPOSE: This study compared the flexural strength of 5 methacrylate-based resins and 8 bis-acryl resins used to fabricate provisional crowns and fixed partial dentures. MATERIAL AND METHODS: Bar-type specimens were fabricated according to American National Standards Institute/American Dental Association specification 27. After being immersed in artificial saliva at 37 degrees C for 10 days, the specimens were fractured under 3-point loading in a universal testing machine at a crosshead speed of 0.75 mm/min. Maximal loads to fracture in Newtons were recorded. Mean flexural strengths were calculated in MPa (n = 10 per group). Comparisons were made with analysis of variance and Duncan's multiple range test (P<.05). RESULTS: Mean flexural strengths ranged from 56.2 to 123.6 MPa. There were 4 statistically similar groups. The group with the highest strengths consisted of 4 bis-acryl materials (Provipont, Integrity, Protemp 3 Garant, and Luxatemp). CONCLUSION: Within the limitations of this study, flexural strengths were material- rather than category-specific. Some, but not all, bis-acryl resins demonstrated significantly superior flexural strength over traditional methacrylate resins.
Using the provisional restoration as a testing ground to increase the predictability of a final restoration is well understood. With the resolution of issues through a well-developed provisional restoration comes the challenge of duplicating its contours in the final prosthesis. A method is described using elastomer impression putty and a molten wax technique by which the contours of a provisional anterior fixed partial denture can be duplicated. The described method is particularly useful when the replication of a specific irregular tooth arrangement is mandated.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
PURPOSE: The aim of the present article was to describe the treatment planning for an implant-supported maxillary fixed prosthesis and the clinical procedure involved, including the laboratory fabrication sequence. MATERIALS AND METHODS: If patients request a fixed prosthesis to restore the edentulous maxilla, it is essential to decide as soon as possible whether this prosthesis design can satisfy the requirements of esthetics, phonetics, comfort, and function. Thus, the crucial clinical factors need to be checked during examination. Furthermore, the relationships between ideal implant angulation, available bone, and intended crown should be assessed using reformatted computed tomography. RESULTS: In patients with minimal bone resorption and limited intermaxillary space, implants can usually be placed in the prosthetically driven implant position for a fixed prosthesis. To evaluate and optimize esthetics, biology, and function, a fixed provisional restoration should be inserted for a 6-month diagnostic period. The ideal provisional then serves as a guide for the final restoration. CONCLUSION: If clinical and radiologic diagnostics indicate that an implant-supported fixed complete denture is feasible, meticulous presurgical planning, precise execution of implant positioning, and a progressive prosthetic treatment sequence are required. The ceramometal fixed implant-supported restoration can then be established in an ideally prepared and matured oral environment.