ABSTRACT
In teeth with furcation involvement, root amputation is one of the treatment choices. A challenge which a dentist may encounter with is the prosthetic treatment of such teeth when their adjacent teeth are intact. According to the current goal of operative dentistry based on conservative treatment, it would be desirable to do in a manner resulting in minimal damage to the adjacent sound teeth. In the following case report, a step-by-step conservative treatment sequences of a mandibular molar with distal root amputation which not involving surrounding teeth is described. During 18 months follow-up, the results were satisfactory.
ABSTRACT
A 61-year-old female patient with adenoid cystic carcinoma (ACC) of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO) and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO) is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD) was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient's normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.
