PMC3652368_01
Preoperative intraoral view of missing teeth.
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Her chief complaint was loss of the upper anterior teeth (maxillary right lateral incisor, maxillary left central incisor) as a result of trauma 6 months earlier, with a request to have these replaced to improve the appearance of the anterior part of her mouth (Figure 1).
Preoperative intraoral view of relationship between upper and lower anterior teeth when posterior teeth are in maximum intercuspation.
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The patient presented with a high smile line (Figure 2).
Frontal view of diagnostic preparation for abutments.
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Afterwards, a completed diagnostic preparation of abutments (Figures 3 and 4) and waxup of the teeth (S-U-Shade-Set wax, Number 5 Intensive-white, Schuler-Dental, Ulm, Germany) and gingiva (modeling wax, Dentsply International, York, PA) were undertaken.
Lateral view of diagnostic preparation for abutments.
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Afterwards, a completed diagnostic preparation of abutments (Figures 3 and 4) and waxup of the teeth (S-U-Shade-Set wax, Number 5 Intensive-white, Schuler-Dental, Ulm, Germany) and gingiva (modeling wax, Dentsply International, York, PA) were undertaken.
Extraction of maxillary right central incisor and maxillary left lateral incisor.
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The Maxillary canines and first premolars were endodontically treated after extraction of the maxillary right central incisor and maxillary left lateral incisor (Figures 5 and 6).
Postoperative periapical radiograph for maxillary right first premolar, maxillary right canine, maxillary left canine, and maxillary left first premolar.
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The Maxillary canines and first premolars were endodontically treated after extraction of the maxillary right central incisor and maxillary left lateral incisor (Figures 5 and 6).
Abutments after preparation.
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Maxillary canines and first premolars) were prepared in a conventional manner using diamond burrs. Margins were 1.2 mm wide and placed 1.0 mm subgingivally (Figure 7).
Alginate checkup impression after abutment preparation.
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An alginate (Orthoprint) impression of the prepared abutments was made and poured using stone (Elite Rock) to check up the preparations and to fabricate a temporary bridge (Figure 8).
Temporary bridge before adding gingival porcelain.
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Wheeling, IL) was mixed and placed in the index and positioned on the cast. A rubber band was wrapped around the index and cast assembly. When the resin was set, the index and temporary bridge were removed from the cast (Figure 9).
Temporary bridge ready for placement.
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Gingival-colored acrylic resin (Lucitone 199 , Dentsply International) was added to the gingival side of the pontic area using a brushing technique (Figure 10).
Temporary bridge being tried in patient's mouth.
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After polymerization of the acrylic resin, the temporary bridge was finished, polished, and tried in the patient's mouth to verify ft, marginal adaptation, and occlusion (Figure 11).
Definitive restoration is luted with interim luting agent.
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The casting try-in was performed one week after the impression was made, and the completed porcelain fused to the metal fixed partial denture was cemented one week after the casting try-in using TempBond (Figure 12).
Definitive restoration after permanent cementation.
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Definitive cementation was performed using glass ionomer cement after one month (GC Fuji I , GC America Inc, Alsop, IL), as shown in Figure 13.