Journal of Oral Implantology August 2013 - (Page 483)
CASE REPORT
Gingival Conditioning in an Implant-Supported
Prosthesis: A Clinical Report
´
Flavio Domingues das Neves, PhD1*
´bio Domingues Silveira-Junior, DDS, MS2
´
Cle
´
Vitor Coro, DDS, MS1
˜
Joao Paulo Silva-Neto, DDS, MSc1
´zar Simamoto-Junior, DDS, MSc, PhD2
´
Paulo Ce
´lio
Ce Jesus do Prado, DDs, MSc, PhD1
The loss of gingival volume is a major challenge for dental surgeons with implant-supported fixed prosthesis
manufactures, particularly from an aesthetics perspective in patients with a high smile line. Gingival tissue
remodeling can help in papillae formation to avoid soft tissue surgery by reestablishing the appropriate shape
and gingival contour of the tissues. This improves not only the aesthetics, but also the phonetics of the patient.
This paper describes a clinical case of gingival conditioning obtained with interim implant-supported fixed
partial dentures via incremental addition and adjustment of acrylic resin. The purpose of the gingival
conditioning was to obtain improved aesthetics. Gingival conditioning by gradual pressure application is
presented as an easy, non-traumatic technique that improves gingival aesthetics.
Key Words: gingiva, fixed partial dentures, aesthetics
INTRODUCTION
T
reatment with osseointegrated implants
and fixed partial dentures has a high
success rate with respect to implant loss
and prosthesis functionality.1 The biggest challenge currently facing dental
surgeons is the creation of favorable esthetics. This
problem is highly dependent upon the maintenance of bone to support soft tissue.2,3 The
resorption of the adjacent alveolar bone results in
loss of gingival volume and interdental papillae.4–6
Common in the anterior maxilla, the condition
increases the difficulty associated with obtaining
adequate gingival esthetics.6–9 This is particularly
true if the smile line of the patient is unfavorable.10
The management of soft tissue to improve
esthetics sometimes requires corrective surgeries,
1
Department of Occlusion, Fixed Prostheses, and Dental
ˆ
ˆ
Materials, Federal University of Uberlandia, Uberlandia, Minas
Gerais, Brazil.
2
ˆ
ˆ
Federal University of Uberlandia, School of Health, Uberlandia.
* Corresponding author, e-mail: neves@triang.com.br
DOI: 10.1563/AAID-JOI-D-10-00199
which are not possible in some cases. Rehabilitation
using a fixed prosthesis over implants is complex
because the residual ridge, pontics, and gingival
papillae must be harmoniously integrated in the
final result.2,3,6,11,12 Given that the use of a provisory
prosthesis can often enhance peri-implant gingival
contour, surgery can be avoided.2,8,9,13,14
This case describes the use of a provisional
prosthesis to enhance esthetics of a Kennedy Class
IV patient with 3 implants. Selective pressure
through the incremental addition of acrylic resin
followed by acrylic adjustment was used to improve
gingival esthetics.
CLINICAL REPORT
A female patient lacking teeth numbers 7, 8, 9, and
10 underwent surgery for implant exposure in the
region of teeth numbers 7, 9, and 10 and healing
abutment installation. The alveolar ridge presented
irregular topography, compromising tooth and soft
tissue esthetics (Figures 1 and 2).
Acrylic resin was utilized to perform gingival
conditioning of the provisional prosthesis in order
Journal of Oral Implantology
483
Table of Contents for the Digital Edition of Journal of Oral Implantology August 2013
Literary Responsibility—Everyone Has a Role to Play
Rehabilitation of Surgically Relocated Integrated Dental Implants With and Without Bone Morphogenesis Protein-2
Erratum
Marginal Fit of Implant-Supported All-Ceramic Zirconia Frameworks
Influence of the Implant Diameter With Different Sizes of Hexagon: Analysis by 3-Dimensional Finite Element Method
Autologous Dental Pulp Stem Cells in Regeneration of Defect Created in Canine Periodontal Tissue
Histologic and Biomechanical Evaluation of 2 Resorbable-Blasting Media Implant Surfaces at Early Implantation Times
Efficacy of Guided Bone Regeneration Using Composite Bone Graft and Resorbable Collagen Membrane in Seibert’s Class I Ridge Defects: Radiological Evaluation
Minimal Iliac Bone Harvesting in Sinus Lift Surgery
Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants
Ultrasonic Oscillations for Conservative Retrieval of a Rare Fracture of Implant Healing Abutment
Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
Gingival Conditioning in an Implant-Supported Prosthesis: A Clinical Report
An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report
Computer Guided Surgery for Implant Placement and Dental Rehabilitation in a Patient Undergoing Sub-Total Mandibulectomy and Microvascular Free Flap Reconstruction
Guided Bone Regeneration for Socket Preservation in Molar Extraction Sites: Histomorphometric and 3D Computerized Tomography Analysis
Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review
Review of Current Literature
Journal of Oral Implantology August 2013
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