Reconstruction of a Worn or Mutilated Dentition with the Utilization of an over Denture Appliance for a Patient with Enamel Deficiency - a Case Report

Abstract

IntroductionThe technique of retaining roots and utilizing an over denture in patients with worn and non-restorable teeth is not a new approach [1,2]. When teeth are extracted, the residual alveolar bone resorbs and continues to resorb over time [3]. The alveolar resorption is greatest in the first months following extraction of teeth, depending upon biological and mechanical factors. However, the rate of resorption on the mandible is faster compared with the maxilla [4]. In addition, greater bone loss was found in the anterior part of the jaws, especially in the mandible [4]. Resorption of the maxilla is apically and poster apically while the mandible is apically and anteroapically. Consequently, if teeth or roots could be maintained in the anterior region of the mandible, it would be a significant benefit to the patient though bones preservation. Prostheses supported by stud type attachments over roots provide a retentive over denture, which is more stable.The use of an over denture attachment system for a partial/ complete removable prosthesis in a patient with endodontically treated retained roots is a predictable approach. The attachment system provides a balanced solution between functional stability and preservation of roots, maintenance of the alveolar bone, cosmetic appeal and economics. Due to the amount of caries and the condition of this young patient's enamel, the treatment option of choice was to preserve the roots of the mandibular teeth. This clinical report describes the placement of an over denture onto endodontically treated abutments utilizing stud attachments. Lithium disilicate ceramic on lays and/or full coverage restorations on the remaining maxillary teeth were utilized to restore the anatomical tooth structure and vertical dimension of occlusion. Full coverage restorations were placed on the maxillary teeth, premolar to premolar, in order to restore the maxillary teeth. Clinical Case ReportA 22-year-old patient presented to the International Comprehensive Program at New York University College of Dentistry with the chief complaint that his teeth keep fracturing and he also did not like their appearance. He wanted them restored in order to improve his smile (Figure 1). He also exhibited halitosis, closed vertical dimension of occlusion, xerostomia and a history of bruxism. During the review of the patient's medical history, we were advised of the use of hormone replacement therapy for transgender (female-to-male) treatment that consists of androgens like testosterone. This therapy may also contribute to this teenage patient's oral conditions, generalized hypoplasia of the enamel; by AbstractBackground: Evidence suggests that the retention of mandibular roots for the preservation of bone in patients by utilizing an over denture is a conservative approach for a fixed and removable prosthetic reconstruction.