Replacing a single missing anterior tooth can be a challenge. Many factors need to be considered when choosing the appropriate treatment. Several treatment options are well established. This case report is to present the use of a cast cobalt chrome partial denture with custom made porcelain tooth to improve aesthetic. The overall shade of the artificial tooth were nicely matched with the adjacent teeth and definite enamel translucency could be achieved which would not be possible with acrylic or even with readymade porcelain tooth.
We investigated the relationship of the maxillary central incisors to the incisive papilla in wearers of complete dentures. First, image analyzer software was used to examine the relationship of the midpoint of the incisive papilla to the labial surface of the maxillary central incisors on occlusal photographs of 120 maxillary casts from dentate Malaysian adults. Then, an Alma denture gauge was used to identify the position of the labial surface of the maxillary central incisors in relation to the midpoint of the incisive papilla in complete dentures from 51 patients who requested replacement dentures at the Faculty of Dentistry, University of Malaya. The mean incisor distance to the incisive papilla in dentate adults was 9.59 ± 1.00 mm, while the mean incisor distance to the incisive papilla in complete dentures was 6.34 ± 1.87 mm. Thus, in our sample of edentulous patients, the anterior teeth in complete dentures were positioned approximately 3 mm closer to the incisive papilla, as compared with the position of the central incisors in natural dentition, and did not duplicate the position of the natural anterior teeth.
In the absence of pre-extraction records, investigators have used various methods to aid in the selection and placement of artificial teeth for complete dentures. Natural tooth position and size provide the dentist with an optimal guide. A study was conducted on a group of ethnic Chinese subjects where direct measurements were made of the arch size and width of the maxillary central incisor on stone casts. The anterior arch width represented by the inter-canine cusp tip distance was 35.74 +/- 2.17mm. The mesiodistal diameter of the maxillary central incisor was 8.85 +/- 0.59mm with a range of 7.60mm to 11.20mm. The results of this study was discussed against other findings on the Caucasian, Nigerian and Malay groups. The significance of artificial tooth selection for dentures was highlighted in relation to the results obtained from the study for the group of Chinese and other races.
Abstract This article describes the clinical and laboratory procedures involved in the fabrication of laboratory-processed, provisional, screw-retained, implant-supported maxillary and mandibular fixed complete dentures incorporating a cast metal reinforcement for immediate loading of implants. Precise fit is achieved by intraoral luting of the cast frame to milled abutments. Effective splinting of all implants is attained by the metal substructure and retrievability is provided by the screw-retention of the prosthesis.