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: 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
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