This therapeutic modality was selected based on the large prosthe

This therapeutic modality was selected based on the large prosthetic space and the patient’s maxillary bone width and height condition, mainly on the right area, which would require bone grafts to obtain a ridge augmentation. The patient was informed about the possible therapeutic modalities and opted for the related treatment. This therapeutic alternative was less complex and time-consuming. In addition,

the use of dental implants in the maxilla would not significantly change the treatment planning for the anterior teeth regarding their periodontal condition. Even if an attachment-retained RPD was not used, these teeth would be splinted to form a stabilized polygon, achieving better long-term prognosis. As regards the periodontal health of the abutments and condition of the residual ridge, mandibular rehabilitation was performed using six dental implants Torin 1 and a full-arch fixed prosthesis. The maxillomandibular relationship, including reestablishment of the curves

of Spee and Wilson and the OVD, was recorded with occlusion rims and an acrylic resin template, according to the metric, phonetic, and esthetic methods (Fig 3). The maxillary cast was oriented on the semiadjustable articulator with a facebow record and the mandibular cast was mounted. The artificial teeth were positioned for an esthetic and functional clinical evaluation. After this, maxillary interim prostheses (anterior crowns and RPD) were obtained. Considering the extensive caries lesions buy LDE225 and the inflammatory pulpal response or pulp breakdown, the maxillary left central incisor, lateral incisor, and canine were endodontically treated. The maxillary right central incisor was submitted to root canal retreatment. According to Torabinejad and Goodacre,[23] it appears that more than 95% of teeth Histamine H2 receptor that have undergone endodontic treatment remain functional over time. Besides the success rates of endodontically

treated teeth used as abutments in RPDs, the maintenance of the remaining teeth present advantages such as proprioception and bone level preservation. Patient psychological factors must also be considered. Considering the absence of coronal dental tissue, which may compromise the bonding procedures for composite cores, only the left central incisor was restored with cast dowel and core. The other teeth were restored using a two-piece dowel/core system (prefabricated metallic dowel/composite core). When the presence of at least 1.5 to 2.0 mm of hard dental tissue structure is limited, and a cervical ferrule may not be gained, the definitive crown seems to be unable to support the masticatory loads.

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