REMOVABLE PROSTHODONTICS – CLINICAL CASES FROM OUR PRACTICE

CLINICAL CASE 1: Temporary white removable prosthetic replacement

We decided on a removable prosthodontic replacement instead of a fixed bridge in the following cases:

when the teeth are in an inappropriate condition for a bridge,
when we don’t want to reduce adjacent teeth by grinding them,
when we need an easier access to perform oral hygiene,
when the patient wants a cheaper replacement.

In the following case we decided on a removable replacement, with which we successfully replaced 3 teeth (2 + 1).

Initial state

With a placed prosthodontic replacement

Initial state from the front

View of the placed prosthodontic replacement

CLINICAL CASE 2: Waiting for the gum to heal for implant insertion

We had to extract the affected tooth because of a granuloma. We had to wait 2 to three months after extraction for the bone and gum to heal. After that we inserted the implant. Then we had to wait 4 to 6 months for it to integrate into the bone, finally we could place the crown.

The period of waitinf for a crown on the implant (normally 6 to 9 months) was very aesthetically disturbing for the patient, that is why we made a white removable tooth replacement for the time being in our practice.

The state at the beginning

Prosthetic replacement on model

Prosthetic replacement in the mouth

CLINICAL CASE 3: Making a prosthodontic replacement which enabled the patient to postpone his decision about a final prosthetic solution

The patient had only two teeth left that weren’t appropriate for any long term solution, that is why he was recommended an extraction. The patient didn’t want this and asked for time to thoroughly think his decision through. That’s why we first made a temporary prosthetic replacement with black clasps which served as a short term temporary solution.

The state at the beginning

The prosthetic replacement in the mouth

Because the patient postponed his decision again (about implants, a removable denture or a combination), we decided to make a more stable and aesthetic long term temporary white removable denture.

Temporary denture with white fasets

CLINICAL CASE 4: White removable denture without metal

The patient wanted to replace his missing teeth with a prosthetic solution that wouldn’t require grinding other teeth. The chosen solution had to be aesthetic without black clasps.

The beginning state

The removable partial denture

Inserted denture

White faset partial denture

From the other side

CLINICAL CASE 5: A combination of nonmetal crowns, a nonmetal joints and nonmetal denture

Instead of choosing metal in crowns, joints and dentures, we chose appropriate white materials that are aesthetically more acceptable.

Model of crowns in CAD CAM

Crowns in oral cavity

Final placement of prostetic solution

KLINIČNI PRIMER 1: Začasen bel snemni protetični nadomestek

Namesto za fiksni mostiček se za snemni protetični nadomestek odločimo:

v primeru neustreznosti obstoječih zob za fiksni mostiček,
ko ne želimo brusiti obstoječih zob,
ko potrebujemo lažje izvajanje ustne higiene,
ko pacient želi finančno ugodnejšo rešitev.

V spodnjem primeru smo se skupaj s pacientom odločili za snemno protetiko, s katero smo uspešno nadomestili 3 zobe (2 + 1).

Začetno stanje

Nameščen protetični nadomestek

Začetno stanje s sprednje strani

Pogled na nameščen protetični nadomestek

KLINIČNI PRIMER 2: Čakanje na zacelitev dlesni z namenom vstavitve implantata

Zaradi granuloma smo morali izpuliti prizadeti zob. Po puljenju je bilo treba počakati 2 do 3 mesece, da sta se kost in dlesen ustrezno zacelila. Nato smo vstavili implantat. Po vstavitvi implantata je bilo treba počakati še 4 do 6 mesecev, da se je ta integriral v kost, šele nato smo lahko namestili prevleko.

Obdobje čakanja na prevleko na implantatu (običajno 6 do 9 mesecev po puljenju zoba) je bilo za pacienta estetsko moteče, zato smo mu v naši ordinaciji za ta čas izdelali bel snemni zobni nadomestek.

Začetno stanje

Protetični nadomestek na modelu

Nameščen protetični nadomestek

KLINIČNI PRIMER 3: Izdelava protetičnega nadomestka, ki je pacientu omogočila preložitev odločitve o izboru končne protetične rešitve

Pacient je imel samo še dva zoba, ki pa nista bila primerna za nobeno trajno protetično rešitev, zato bi ju bilo najbolje izpuliti. Pacient tega ni želel in je prosil za čas, da temeljito razmisli o končni odločitvi. Sprva smo mu zato izdelali začasni protetični nadomestek s črnimi zaponami, ki je služil kot kratkotrajna začasna rešitev.

Začetno stanje

Nameščen protetični nadomestek s črnimi zaponami

Ker je pacient svojo odločitev o končni obliki protetične rešitve (implantat, proteza ali kombinacija obeh) še odložil, smo se odločili za izdelavo bolj stabilnega in estetskega dolgotrajnega začasnega belega snemnega protetičnega nadomestka.

Nameščen protetični nadomestek z belimi fasetami

KLINIČNI PRIMER 4: Bela brezkovinska delna proteza

Pacient si je želel nadomestiti manjkajoče zobe s protetično rešitvijo, pri kateri mu ne bi bilo treba brusiti zob. Izbrana rešitev je morala biti estetska, torej brez motečih črnih zapon.