Page 36 - Dental Practice Vol 17 No.5_

prosthetic section

IT IS TIME FOR MINIMALLY INVASIVE

PROSTHETIC DENTISTRY

MAHESH CHAUHAN

The concept of minimally invasive operative dentistry was well exfoliated tooth #41 and brought it to us to ‘show’ what had hap-
established long ago. There is already an emphasis on the surgical pened.
procedures to be done like delicate periodontal procedures as well, There was a great sense of relief on his face when I said that his
so what about prosthetic dentistry? own tooth could be used as a Natural Tooth Pontic and alongside
When we think of prosthetic dentistry, we often think of the need his other mobile incisors can be stabilized with an overall improve-
to perform extensive treatment planning, need for extra equipment, ment in esthetics too.
dependence on many dental materials, expensive and time consum- Dental materials that are available today for splinting teeth can
ing laboratory work.When we think of a prosthetic rehabilitation also be successfully used for newer applications such as shown here.
with implants, it involves much more of everything starting from a The common steps of cleaning and isolating teeth followed by etch-
CBCT for treatment planning, which is followed by surgery then the ing, bonding and then applying the FRC material remain same. A
prosthetic phase. crucial step in long-term clinical success remains proper adaptation
Mobility of teeth is a slowly progressive outcome of an underly- of the FRC material and its light curing. Maximizing the FRC to
ing periodontal disease in most cases. Seldom, it may be due to other enamel contact surface area.
factors such as trauma, trauma from occlusion, lesions of endodon- The FRC materials are susceptible to water absorption and this
tic origin or in rare cases cervical root resorption. affects their physical properties adversely, therefore they must be
Since chronic periodontitis is a slowly progressing disease and coated fully with composite. Example of FRC materials are Fiber
rarely causes acute pain, there is a tendency among sufferers to delay Splint & F-Splint Aid by POLYDENTIA SA, EverStick C & B,
seeking treatment, to the point in time that the involved tooth or EverStickPerio by GC, Ribbond etc.
teeth become increasingly ever mobile and sometime reaches a stage The whole beauty of this minimally invasive prosthesis is that it
of exfoliating. Such a patient then seeks treatment for replacement is very esthetic, economical and accomplished using minimum den-
for the lost tooth. The dentist then faces the situation in which there tal materials without depending on any extensive or expensive
is very little bone left in the edentulous area to place an implant equipment or laboratory fabrication. Unlike in a procedure like
since slow bone resorption was going on in that area for a long time crown preparation which requires preparation of two adjacent teeth
resulting in not only a bucco-lingual loss but a vertical bone loss as and also generates a lot of aerosols resulting in more exposure and
well. risk of high viral load transmission. Compared to a dental implant
If we consider a FPD in that area and often times we see that the it is non-surgical, non-invasive, economical and a quicker therapy
abutments themselves are shaky and sensitive due to marked bone enhancing patient acceptability. Over the years, I have done numer-
loss and then the cost of a 3-unit or 4-unit FPD sometimes equals or ous such prosthesis and have had very good success with their long
exceeds the cost of an implant. term functioning.
A geriatric patient specially might not be willing to spend a whole The process of Natural Tooth Pontic follows below in this picto-
lot of time and money on the procedures as well and the ideal situ- rial case presentation.
ation would be to preserve what is there and involve minimum
intervention and minimum cost.
Here is an example of a male patient in his early seventies with a
mandibular right central incisor that was already affected by peri-
odontal disease and got self-exfoliated.
The adjacent tooth i.e. the mandibular left central incisor had a
strange wear from all sides and hence needed a shape correction for
better esthetics. Fortunately, the patient did not throw away his

Article Citation
Chauhan, M. (2021).It is time for minimally invasive pros-
thetic dentistry.Dental Practice, 17(5), 36-38
FIG 1A: Male Patient in his early seventies whose tooth #41 was loose got self-
exfoliated

36 Dental Practice // May-June 2021 // Vol 17 No 5