PMC9807957_01
(a, c and e) Case 1 (prerehabilitative view, inter-arch relation, maxillary intraoral view), (b, d, and f) Case 2 (prerehabilitative view, inter-arch relation, maxillary intraoral view.
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F1
Intraoral examination revealed maxillary left lateral incisor (22) with mild generalized fluorosis (according to dean fluorosis index) [Figure 1b, d and f].
PMC9807957_02
(a, c and e) Case 1 (prerehabilitative view, inter-arch relation, maxillary intraoral view), (b, d, and f) Case 2 (prerehabilitative view, inter-arch relation, maxillary intraoral view.
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F1
Intraoral examination revealed maxillary left lateral incisor (22) with mild generalized fluorosis (according to dean fluorosis index) [Figure 1b, d and f].
(a, c, and e) Case 1 (diagnostic impression and cast, maxillary and mandibular cast mounted in an articulator), (b, d, and f) Case 2 (diagnostic impression and cast, maxillary and mandibular cast mounted in an articulator).
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F2
Diagnostic impression was made using irreversible hydrocolloid (Algitex Alginate Impression Material-Dental Product of India) [Figure 2a and b]. Ltd.) [Figure 2c and d]. Maxillary and mandibular cast was mounted on a mean value articulator [Figure 2e and f].
(a) Putty index, (b) Tooth preparation (full veneer preparation in 22 and lingual window preparation in 11), (c) Final impression, (d) Provisional restoration (e). Metal try in (f). Final prosthesis after porcelain firing and glazing.
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F3
The putty index was made over the same for fabrication of provisional restoration [Figure 3a]. Since it is a hybrid Maryland bridge, full veneer preparation of maxillary left lateral incisor and lingual window preparation of maxillary right central incisor was carried out in patient's mouth [Figure 3b]. The final impression was made using addition silicone putty and light body (LB) elastomeric impression material (Avue Gum Putty and LB: Hydrophilic Vinyl Polysiloxane Impression Material) [Figure 3c]. Acrylic Crown and Bridge Material) using direct technique. After polymerization, adequate trimming and polishing was done and provisional restoration was cemented using temporary luting material (Ammdent Temp-Ting Temporary Luting Material) [Figure 3d]. The metal try in was carried out in the patient's mouth [Figure 3e] after which the conventional porcelain layering, firing, glazing, finishing, and polishing was done [Figure 3f].
(a) Final prosthesis in master cast (b) Final prosthesis in situ, (c) Final prosthesis in situ (occlusal view) (d) Postrehabilitative view.
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F4
The final prosthesis was evaluated for marginal fit and occlusion, initially on cast and then in patient's mouth [Figure 4a-c]. The bonding agent was applied and the prosthesis was cemented using dual cure resin cement (Dental avenue Avue nano core dual) and cured using light curing unit [Figure 4d].
(a) Putty index cut in the middle to replace with Chemi-sil, (b) Chemi-sil application (c) Provisional restoration composite material, (d) Tooth preparation (window preparation in 21 and 23), (e) Injecting the flowable composite after placing putty index in prepared tooth, (f) Provisional restoration.
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F5
The lingual window preparation was done in maxillary left central incisor and canine, followed by final impression and fabrication of master cast same as in Case 1 [Figure 5d]. The putty index was made with clear heavy body elastomeric material (Poly Vinyl Silicone Clear LB - ChemiSil [Korean]) which allows blue curing light to pass through the material [Figure 5a]. An injecting tip was attached to the putty index for injecting the composite material [Figure 5b]. The putty index was placed in the patient's mouth and flowable composite was injected using the tip attached and was light cured [Figure 5c-f].
(a) After scanning of master cast, the maxillary scanned model in EXOCAD software, (b) CAD Designing of pontic, (c) Designing of two wings on prepared tooth, (d) Final prosthesis after Milling in CAM machine, (e) Final prosthesis in situ, (f) Postrehabilitative view. CAD: Computer-Aided Designing, CAM: Computer-Aided Manufacturing.
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F6
USA) and after that designing was done using EXOCAD software (exocad GmbH, Darmstadt, Germany) [Figure 6a]. Utilizing CAD technology, the preparations were delineated and the pontic was designed [Figure 6b and c]. Thereafter, grapheme-based polymer disc (G-CAM Disc) was incorporated and the prosthesis was dry milled in Dentsply Sirona-inLab MC X5 milling machine (Dentsply Sirona Global headquarters, Charlotte, NC 28277, USA) [Figure 6d]. The prosthesis was then stained and glazed with light curing materials and cured and assessed initially on cast and then in patient's mouth, followed by cementation using resin cement similar to Case 1 [Figure 6e and f].