Nonsurgical gingival displacement in restorative dentistry.

Gingival displacement is critical for obtaining accurate impressions for the fabrication of fixed restorations, especially when the finish line is at or just within the gingival sulcus. Displacement of the gingival tissue is also important when dealing with the restoration of cervical lesions due to their proximity to the periodontal tissue. The methods of gingival tissue displacement can be broadly classified as nonsurgical and surgical techniques, with nonsurgical being the more commonly practiced method. Dentists must alter their armamentarium and gingival displacement techniques to meet specific demands and obtain predictable results. Hence, the purpose of this article is to describe the different means by which nonsurgical gingival displacement can be achieved effectively under a variety of clinical situations.

Management of a patient with congenitally missing lateral incisor: a multidisciplinary team approach / Tratamento de um paciente com ausência congênita de um incisivo lateral: uma abordagem multidisciplinar

OBJECTIVE: The present paper highlights a case where the patients presented with spacing in the upper anterior region due to missing right lateral and peg shaped left lateral incisor. METHOD AND RESULTS: The initial treatment was standard edgewise fixed orthodontic appliance to distalize the canine, correct the bite and create space for the lateral incisors and correct the midline. CONCLUSION: After the active phase of fixed orthodontic treatment, an implant was placed and the peg shaped lateral incisor was built up with composite.

OBJETIVOS: O presente artigo refere-se a um caso em que o paciente apresentava espaços na região anterior da maxila devido à ausência de incisivo lateral direito e incisivo lateral esquerdo com coroa deformada. MÉTODO E RESULTADO: O tratamento inicial foi ortodontia fixa (edgewise) para distalizar o canino, corrigir a mordida e criar espaço para o incisivo lateral e corrigir a linha média. CONCLUSÃO: Após a fase ativa da ortodontia, utilizou-se um implante adequado na região do lateral direito e reconstruiu-se a coroa deformada do incisivo lateral esquerdo com compósito.

Clinical diagnosis and oral rehabilitation of a patient with amelogenesis imperfecta: a case report.

AIM: This clinical report describes the oral rehabilitation of a young female patient diagnosed with the hypocalcified, autosomal recessive type of Amelogenesis imperfecta (AI). A brief discussion on diagnosis of AI is also included. BACKGROUND: AI has been defined as a group of hereditary enamel defects not associated with evidence of systemic disease. It can be characterized by enamel hypoplasia and/or hypomaturation or hypocalcification of the existing teeth. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation and the protection of these teeth. REPORT: A 31-year-old female patient presented with concerns including extreme sensitivity; dissatisfaction with size, shape, and shade of teeth; and poor masticatory efficiency. She was very conscious about the appearance of her teeth and reported that her primary dentition was affected in the same manner. The specific objectives of this treatment were to eliminate tooth sensitivity, enhance esthetics, and restore masticatory function. Treatment included crown lengthening procedures and placement of anterior and posterior metal-ceramic crowns. A 12-month follow-up with clinical and radiographic examinations revealed no evidence of any untoward effects of the treatment on the restored teeth or their supporting structures. SUMMARY: Management of a patient with AI is a challenge for the clinician. The treatment options vary considerably depending on several factors such as the age of the patient, socio-economic status, periodontal condition, loss of tooth structure, severity of the disorder, and, most importantly, the patient's cooperation. The clinician has to consider the long-term prognosis of the treatment outcome. This clinical report describes the fabrication of metal ceramic and all metal crowns for the restoration of severely worn teeth in a patient with AI which requires meticulous maintenance of oral hygiene and patient co-operation.

Prosthetic rehabilitation of a complete bilateral maxillectomy patient using a simple magnetically connected hollow obturator: a case report.

AIM: The purpose of this clinical report is to present a description of the prosthetic rehabilitation of a bilateral complete maxillectomy patient using a two piece magnetically connected prosthesis. BACKGROUND: A complete bilateral maxillectomy defect presents a considerable reconstructive challenge for the prosthodontist. It results in devastating effects on cosmetic, functional, and psychological aspects of the patient. REPORT: A 46-year-old woman reported with a chief complaint of missing teeth in the upper jaw. Her primary concerns were a poor facial appearance, inability to chew food, and regurgitation of the food into the nasal cavity. She was diagnosed with carcinoma of the maxillary sinus, for which a bilateral maxillectomy was done followed by post surgical radiation therapy. The prosthetic treatment objectives were to separate the nasal and oral cavities, restore the mid-facial contour, and improve her masticatory functions by providing a full complement of maxillary teeth using a two-piece connected hollow obturator prosthesis connected by a magnet. SUMMARY: Insertion and removal of a large prostheses used for rehabilitation of midfacial defects requires good neuromotor coordination and an adequate mouth opening. Because these factors were problematic for this patient, the treatment plan was to fabricate a two piece magnetically connected prosthesis. After fabrication and insertion of the prosthesis, the fit between two sections was evaluated and instructions for insertion, removal, and maintenance of the obturator were given. The patient's speech, masticatory efficiency, and swallowing dramatically improved after insertion.