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A root submergence technique for pontic site development in fixed dental prostheses in the maxillary anterior esthetic zone.

Choi S, Yeo IS, Kim SH, Lee JB, Cheong CW, Han JS - J Periodontal Implant Sci (2015)

Bottom Line: The submerged roots at the pontic sites preserved the surrounding periodontium without any periapical pathology.The gingival contour at the pontic site was maintained in harmony with those of the adjacent teeth, as well as the overall form of the arch.The results of this clinical report indicate that a root submergence technique can be successfully applied in pontic site development with fixed dental prostheses, especially in the maxillary anterior esthetic zone.

View Article: PubMed Central - PubMed

Affiliation: Department of Prosthodontics & Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.

ABSTRACT

Purpose: This case report discusses the effect of a root submergence technique on preserving the periodontal tissue at the pontic site of fixed dental prostheses in the maxillary anterior aesthetic zone.

Methods: Teeth with less than ideal structural support for fixed retainer abutments were decoronated at the crestal bone level. After soft tissue closure, the final fixed dental prostheses were placed with the pontics over the submerged root area. Radiographic and clinical observations at the pontic sites were documented.

Results: The submerged roots at the pontic sites preserved the surrounding periodontium without any periapical pathology. The gingival contour at the pontic site was maintained in harmony with those of the adjacent teeth, as well as the overall form of the arch.

Conclusions: The results of this clinical report indicate that a root submergence technique can be successfully applied in pontic site development with fixed dental prostheses, especially in the maxillary anterior esthetic zone.

No MeSH data available.


Radiographic images and a clinical photograph of the patient in Case 1. (A) Intraoral radiographic image at the patient's first visit. (B) Intraoral radiographic image three months after the removal of an existing restoration and endodontic treatment on the maxillary right lateral incisor. (C) Intraoral radiographic image two years after the delivery of a final fixed dental prosthesis. (D) Clinical photograph two years after the delivery.
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Figure 1: Radiographic images and a clinical photograph of the patient in Case 1. (A) Intraoral radiographic image at the patient's first visit. (B) Intraoral radiographic image three months after the removal of an existing restoration and endodontic treatment on the maxillary right lateral incisor. (C) Intraoral radiographic image two years after the delivery of a final fixed dental prosthesis. (D) Clinical photograph two years after the delivery.

Mentions: A 63-year-old male patient presented to the clinic with the complaint of movement in a maxillary anterior prosthesis that had been placed five years ago. Clinical and radiographic examinations revealed that his maxillary right lateral incisor, used as the abutment tooth for a three-unit fixed dental prosthesis, had a secondary caries with inadequate structural support, causing bucco-lingual movement of the prosthesis. A noteworthy finding in this prosthesis was a maxillary right central incisor root remnant, which had been covered by soft tissue and remained for five years underneath the pontic site (Fig. 1A). The radiographic and clinical evaluation showed no inflammation, dehiscence, external root resorption, or any known pathologies, and the arch form was maintained without any sign of ridge deformation. It was evident that a submerged root of the maxillary right central incisor had prevented bone resorption, especially in the interproximal area. Due to the severe secondary caries, the prognosis for the maxillary right lateral incisor was poor: it was thus submerged as a root remnant at the pontic site. The tooth was endodontically treated due to the periapical lesion, then decoronated at a crestal bone level similar to that of the maxillary right central incisor. No surgical intervention was performed, and an interim fixed dental prosthesis supported by the maxillary right canine and maxillary left central incisor was fabricated, relieving pressure on the soft tissue under the pontic sites. After a three-month healing period, the root was completely covered by soft tissue, and the periapical lesion was disappeared (Fig. 1B). No noticeable changes were observed in the alveolar ridge of the pontic site either vertically or horizontally. Upon completion of the healing process, a metal ceramic fixed dental prosthesis was fabricated and cemented with a resin-modified glass-ionomer cement. Since the submerged roots preserved the bone and soft tissue, the gingival contour of the pontic site was in harmony with the gingival margins of the adjacent abutment teeth. At a two-year follow-up visit, the bone level at the submerged root site was stable, and the gingival contour under the pontic site was maintained (Fig. 1C, D). The patient was satisfied with the outcome of the prosthetic rehabilitation.


A root submergence technique for pontic site development in fixed dental prostheses in the maxillary anterior esthetic zone.

Choi S, Yeo IS, Kim SH, Lee JB, Cheong CW, Han JS - J Periodontal Implant Sci (2015)

Radiographic images and a clinical photograph of the patient in Case 1. (A) Intraoral radiographic image at the patient's first visit. (B) Intraoral radiographic image three months after the removal of an existing restoration and endodontic treatment on the maxillary right lateral incisor. (C) Intraoral radiographic image two years after the delivery of a final fixed dental prosthesis. (D) Clinical photograph two years after the delivery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556801&req=5

Figure 1: Radiographic images and a clinical photograph of the patient in Case 1. (A) Intraoral radiographic image at the patient's first visit. (B) Intraoral radiographic image three months after the removal of an existing restoration and endodontic treatment on the maxillary right lateral incisor. (C) Intraoral radiographic image two years after the delivery of a final fixed dental prosthesis. (D) Clinical photograph two years after the delivery.
Mentions: A 63-year-old male patient presented to the clinic with the complaint of movement in a maxillary anterior prosthesis that had been placed five years ago. Clinical and radiographic examinations revealed that his maxillary right lateral incisor, used as the abutment tooth for a three-unit fixed dental prosthesis, had a secondary caries with inadequate structural support, causing bucco-lingual movement of the prosthesis. A noteworthy finding in this prosthesis was a maxillary right central incisor root remnant, which had been covered by soft tissue and remained for five years underneath the pontic site (Fig. 1A). The radiographic and clinical evaluation showed no inflammation, dehiscence, external root resorption, or any known pathologies, and the arch form was maintained without any sign of ridge deformation. It was evident that a submerged root of the maxillary right central incisor had prevented bone resorption, especially in the interproximal area. Due to the severe secondary caries, the prognosis for the maxillary right lateral incisor was poor: it was thus submerged as a root remnant at the pontic site. The tooth was endodontically treated due to the periapical lesion, then decoronated at a crestal bone level similar to that of the maxillary right central incisor. No surgical intervention was performed, and an interim fixed dental prosthesis supported by the maxillary right canine and maxillary left central incisor was fabricated, relieving pressure on the soft tissue under the pontic sites. After a three-month healing period, the root was completely covered by soft tissue, and the periapical lesion was disappeared (Fig. 1B). No noticeable changes were observed in the alveolar ridge of the pontic site either vertically or horizontally. Upon completion of the healing process, a metal ceramic fixed dental prosthesis was fabricated and cemented with a resin-modified glass-ionomer cement. Since the submerged roots preserved the bone and soft tissue, the gingival contour of the pontic site was in harmony with the gingival margins of the adjacent abutment teeth. At a two-year follow-up visit, the bone level at the submerged root site was stable, and the gingival contour under the pontic site was maintained (Fig. 1C, D). The patient was satisfied with the outcome of the prosthetic rehabilitation.

Bottom Line: The submerged roots at the pontic sites preserved the surrounding periodontium without any periapical pathology.The gingival contour at the pontic site was maintained in harmony with those of the adjacent teeth, as well as the overall form of the arch.The results of this clinical report indicate that a root submergence technique can be successfully applied in pontic site development with fixed dental prostheses, especially in the maxillary anterior esthetic zone.

View Article: PubMed Central - PubMed

Affiliation: Department of Prosthodontics & Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.

ABSTRACT

Purpose: This case report discusses the effect of a root submergence technique on preserving the periodontal tissue at the pontic site of fixed dental prostheses in the maxillary anterior aesthetic zone.

Methods: Teeth with less than ideal structural support for fixed retainer abutments were decoronated at the crestal bone level. After soft tissue closure, the final fixed dental prostheses were placed with the pontics over the submerged root area. Radiographic and clinical observations at the pontic sites were documented.

Results: The submerged roots at the pontic sites preserved the surrounding periodontium without any periapical pathology. The gingival contour at the pontic site was maintained in harmony with those of the adjacent teeth, as well as the overall form of the arch.

Conclusions: The results of this clinical report indicate that a root submergence technique can be successfully applied in pontic site development with fixed dental prostheses, especially in the maxillary anterior esthetic zone.

No MeSH data available.