Prosthodontic Treatment Using Vital and Non Vital Submerged Roots-Two Case Reports

Abstract

A 46-year-old male patient reported to the department of Prosthodontics for replacement of the missing teeth [Table/ Fig-1]. In order to select the patient for root submergence treatment medical history, dental history and history of habits was noted, clinical examination, both intra-oral and extra-oral was done. For thorough examination OPG was advised . It was seen that there were multiple decayed teeth which cannot be restored and many teeth were missing. Teeth 11,21,22,31 were extracted due to caries. With the remaining teeth that cannot be used as abutments for fixed prosthetic treatment, it was decided that root submergence could be the choice of treatment. The patient was informed about root submergence method of treatment, its advantages and disadvantages. With the patients consent vital root submergence treatment was selected.Further evaluation was done after a healing period of one month. In the vital submergence technique, as the vitality of the root has to be maintained, the teeth indicated for submergence were treated as atraumatically as possible. The vital root submergence procedure was carried by reflecting the full thickness flap. The coronal part of the teeth selected for vital submergence (13,14,23,33,34,35,41,42,43,44) was reduced to 2 mm below the alveolar crest using a chisel and a mallet slowly such that the vitality of the tooth is not effected . Once the tooth was sectioned 2mm below the alveolar crest, the irregular / sharp surface of the sectioned teeth and surrounding bony irregularities were smoothened using a round bur and straight hand piece under copious irrigation ensuring well rounded and smooth edges to the hard tissue. Using a bone file, the interdental bone is smoothened. The flap is then approximated to evaluate for complete closure.The flap was sutured and primary closure was obtained [Table/ Fig-4]. Patient was recalled after 7 days for suture removal. After satisfactory healing an assessment of the intra arch space available was recorded [Table/ Fig-5]. The Interarch space was 18mm for this patient, which was sufficient for fabrication of a complete over denture prosthesis supported by the underlying vital submerged roots. The over denture was fabricated in the conventional method by making the preliminary impressions followed by border molding using a special tray with full spacer such that relief was given to the entire alveolar ridge with submerged roots. Light body polyvinlysiloxane was used for the wash impression so that accurate details were recorded. Jaw relations were recorded followed by face bow transfer using Hanau spring bow. Gothic arch tracing followed by centric and protrusive records were obtained for programming the Hanau wide vue Arcon 183-2 articulator, for balanced occlusion. Teeth arrangement was done in the neutral zone so that the forces laid by the denture are well distributed on all the remaining hard tissues such that further resorption of the residual ridge is reduced and clinical exposure of the retained roots is prevented. During Tryin, prop...

Tooth-Supported Overdentures Revisited

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Thermoplastic Mandibular Tooth Supported Overdentures Versus Acrylic One (Maxillary Tissue Changes).

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Tooth Supported Overdenture for Partially Edentulous Denture Using Magnetic Attachment -A Case Report

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