Management of severely protruded anterior teeth with fixed partial denture: a case report

ABSTRACT

The presence of diastema is often considered as a problem affecting the appearance of patients. This situation will be more complicated when severe proclination of teeth is present. Limited treatment options are available. Orthodontics is the first-line treatment option. Some conditions can interfere with its indication such as the patient's age and the severity of teeth protrusion. The use of conventional fixed dental prosthesis is another therapeutic option. Due to atypical peripheral preparation, dental axes can be redressed but the closure of diastema can lead to wide anaesthetic anterior prostheses. This paper proposes another therapeutic option to treat patient having a severe dental protrusion associated with diastema. She was 40-year-old female. Her chief complaint was tooth spacing and improper appearance of the maxillary anterior teeth. Oral examination showed protruded upper and lower incisors with the presence of large diastema. Considering the importance of the alveolar protrusion, orthodontic treatment was impossible. The therapeutic decision was the use of fixed partial denture. Closing diastema by increasing mesiodistal diameters of crowns lead to enlarged and unsightly dental units. To deal with this problem, the extraction of two central and lateral incisors was proposed. Six teeth will replace these four extracted teeth two central incisors and four lateral incisors. Provisional prostheses were performed from diagnostic wax. Once the treatment project is tested and validated by the patient, the definitive stage was started. Overbite, over jet and the patient profile were improved and the patient expressed her great satisfaction