K.L.E'S. INSTITUTE OF DENTAL SCIENCES, BELGAUM ESTHETIC TRANSFORMATION - A Clinical Report DR KAMAL SHIGLI DR GANGADHAR.S.A. M.D.S M.D.S. Associate Professor Professor. DEPARTMENT OF PROSTHODONTICS K.L.E'S. INSTITUTE OF DENTAL SCIENCES, BELGAUM

Decreased vertical height Deep bite Deranged occlusal plane

Labially placed 11, 12, 21, 22. Root pieces with 14,16,17,26, 36&46 Grossly destructed 24&37

Grossly destructed 37

TREATMENT PLAN INCLUDED : Extraction of root pieces & 11, 12, 21, 22& 24 Alveoloplasty of maxillary labial region Fabrication of maxillary immediate partial denture Intentional RCT for 13,15,23& 25 Restoration of mandibular occlusal plane

Maxillary Immediate Partial Denture

Restoration of Mandibular Occlusal Plane

“A removable partial denture or complete denture that covers and rests on one or more remaining natural teeth,the roots of natural teeth,and or dental implants;a prosthesis that covers and is partially supported by natural teeth,natural tooth roots,and or dental implants.” It is also called : Overlay denture, Overlay prosthesis, Superimposed prosthesis

Three different abutment categories: Non coping, Coping and Attachments

Advantages of an Overdenture Preservation of alveolar bone Proprioceptive feedback Support Retention Psychological aspect Convertibility

Disadvantages of an Overdenture Plaque retention Secondary caries Encroachment of the interocclusal distance Need for endodontics • Bulk of attachments & tissue undercuts Difficulty in achieving shade Cost

Before After

Before After

The long-term success of using teeth as overdenture abutments has been well documented. A study by Crum and Rooney compares bone loss between patients with conventional dentures and patients with overlay dentures.By retaining the mandibular cuspids in the use of an overdenture,the resorption of the alveolar bone surrounding these teeth was reduced by eight times. Toolson and Taylor showed that,over 10years, 66 out of 77 abutments survived and,of the 11 that failed,6 were due to secondary caries.

SUMMARY A changing paradigm in the treatment planning of patients with a compromised dentition includes an understanding that sometimes it is better to extract non-strategic or severely compromised teeth and to use the natural teeth in a key position for an overdenture.

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