A Simple Solution to a Complex Problem
by Nicholas Miller, DMD, MS, FACP, Board Certified Prosthodontist | Georgia Prosthodontics
Case Summary
Treatment to Removable Partial Denture included
After collecting diagnostic information and consult with ENT (ENT was consulted due to involvement of cyst with maxillary sinus), the patient was presented with several treatment options:
• Consult with OMFS for bone graft with donor site possible from tibia or floating rib in preparation for placement of dental implants for fixed prosthesis
• Combination of block graft and orthodontics. A block graft would be completed prior to orthodontics then tooth #14 would be moved into occlusal plane.
After orthodontics re-evaluation would be needed for the need for more block graft prior to implants at sites #11, 12.
• Fixed partial denture #10-14 with gingival replacement
• Removable partial denture to replace teeth #11, 12.
• Do nothing.
After evaluating the treatment options Rebecca chose the least invasive option, a removable partial denture, to replace missing teeth #11, 12 and prosthetically align #14.
The classic sequence of treatment was followed to fabricate the RPD:
• Preliminary impressions and analysis with surveyor
• Tooth preparations including rest preps #2, 3, 15 and guide planes #14, 10
• Fabrication of metal RPD framework with mesh in edentulous area and over tooth #14
• Milled PMMA teeth #11, 12, 14
• Try-in of framework with teeth to evaluate esthetics and occlusion
• Process RPD using Ivobase system
• Delivery of prosthesis to patient.
When treatment planning complex prosthodontic cases it is very important to give the patient all the treatment options and sequence. This specific case has non-invasive and short time commitment treatment options to invasive and long time commitment options.
It is important that the patient knows all the options so they know how a treatment decision now could affect treatment options in the future
Treatment Outcome
Rebecca underwent a procedure to create a partial denture and is very happy with the results. She is pleased with the way she looks and has adapted well to the new device. She can now smile, speak and eat comfortably.
If you have comments or questions about Rebecca’s case, please email me at: smileagain@gaprostho.com
As a Prosthodontist, I often coordinate with a patient’s general dentist and other dental specialists that they’ve seen.
If you have a patient in a similar situation and would like to team up for either the surgical or surgical and restorative planning of a similar case we would be happy to assist you.
How can a Certified Prosthodontist assist you and your dental team?:
We specialize in the treatment of complex cases, usually involving several procedures over months of care. The next time you see a challenging case, please feel free to call us and we can discuss treatment planning or help you with any part of the treatment. Our goal is to be a resource for your office by helping manage difficult and time-consuming procedures, restoring the function and esthetics that each patient desires, then referring them back to your office for their ongoing care.
If you have a patient with several missing, broken, or severely worn teeth they may be a candidate for oral rehabilitation with the assistance of a Prosthodontist.