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Specialist in Prosthodontics working in Private Practices in Kent and Sussex; Clinical Lecturer for Health Education England London and Kent, Surrey and Sussex
An 86 year old lady presented with numerous missing teeth, failing restorations, unstable dentures and a fractured provisional crown on her upper left canine. After a thorough pre-operative assessment and diagnostic planning, provisional restorations were provided to help the definitive treatment planning. The prosthodontic treatment involved fixed prostheses in the maxillary arch, followed by maxillary and mandibular tooth and mucosa supported cobalt chromium removable prostheses. This was provided at an increased occluso-vertical dimension in centric relation.
CPD/Clinical Relevance: This article illustrates techniques to optimize removable partial prostheses by using abutment teeth to their full potential.
Article
Alterations on abutment teeth to improve guide planes, undercuts, rests and other features can be beneficial to the outcomes of removable partial dentures (RPDs).1 Indirect restorations on abutment teeth is another technique used to this end.2 This case report explores the use of indirect restorations, helping the practitioner to be more mindful of these options when planning RPD work.
First, abutment teeth should be identified for their suitability, taking into consideration their restorative, periodontal and endodontic status (Table 1). If a tooth is periodontally compromised then it is best not to consider it as an important denture abutment, but rather plan for its future failure. Conversely, a periodontally sound but heavily restored lone standing molar may be an ideal candidate for cuspal coverage as this would reduce the risk of its future fracture, while at the same time providing customized retention and support to the RPD.
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