PMC7396078_01
Results of the dental examination (12/2014).
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The examination of the extraoral facial area and the oral mucosa revealed no abnormalities; the intraoral dental and X-ray status are presented in Figure 1.
Periodontal status of the patient (a) in May 2015, (b) before (01/2016) and (c) after active, nonsurgical periodontal treatment (10/2016), and (c) at follow-up (10/2019).
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The initial active periodontal therapy as well as endodontic treatment was initiated (Figures 2(a) and 3). The diagnosis after measurements for the periodontal status was severe periodontitis (Stage IV, Grade C, Figure 2(b)). Dentsply Sirona, York, Pennsylvania, USA), and "modified Winkelhoff Cocktail," i.e., 3 x 500 mg amoxicillin plus 3 x 400 mg metronidazole for 7 days, was applied in May 2016. During several follow-ups scheduled in a range of seven days, three weeks, three months, and five months, no complaints occurred and the periodontal parameters (PPD and attachment loss (AL)) improved (Figure 2(c)). IV, Grade C) was observed (Figure 2(d)). In December 2019, a fracture of the splint in regio 24/25 was examined (Figure 8(a)).
Esthetical appearance of the patient after extraction of tooth 23.
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To compensate the esthetical shortcomings after loss of the canine (Figure 4), the patient was supplied with a temporary RPD.
Preparation design of the abutment teeth for the (a) 3-unit FDP and (b) fiber-reinforced resin composite splint.
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Italy) and a resin composite (Signum composite, Kulzer, Hanau, Germany) should be chosen, which could be adhesively luted to an artificial denture tooth (VITAPAN PLUS, VITA Zahnfabrik). In May 2018, the preparation of the 3-unit FDP was realized in accordance with the guidelines of the manufacturer and the abutment teeth of the splint were prepared slightly, only touching the enamel, to ensure the same direction of insertion (Figures 5(a) and 5(b)).
The (a) 3-unit FDP and (b) fiber-reinforced resin composite splint after fabrication.
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Afterwards, a conventional impression was taken using a polyvinyl siloxane impression material (Aquasil Ultra Heavy and Aquasil Ultra+ XLV, Dentsply Sirona) and the restorations were fabricated labside (Figures 6(a) and 6(b)).
Esthetical appearance of the patient after insertion.
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The try-in procedure of the FDP and the splint revealed that the patient was pleased with oral comfort and his esthetical appearance (Figure 7).
At follow-up, a fracture of the splint was observed in regio 24/25 (a), which was repaired utilizing sandblasting, a universal primer, and a direct composite (b-c), follow-up (d).
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IV, Grade C) was observed (Figure 2(d)). In December 2019, a fracture of the splint in regio 24/25 was examined (Figure 8(a)). For repairing purposes, the fractured parts were slightly removed with a bur and roughened by using sandblasting (CoJet, 3M, Seefeld, Germany) (Figure 8(b)). Afterwards, a direct resin composite (ceram.x, Dentsply Sirona) was used to connect the fractured ends of the splint (Figure 8(c)). The patient did not describe any complaints or complications (Figure 8(d)).