Contests The Prosthocontest 2019/ 29 May 2019/

Case 92 | Sebastian Ercus – Romania | Prosthocontest2019

Sebastian Ercus

Interdisciplinary teamwork by Sebastian Ercus (prosthodontics&restorative), Muriel Krischek (perio-implants), Vandevelde (master dental ceramist)

Patient was referred to us in order to find a solution for her 4 upper anterior teeth.
CBCT showed chronic periapical infections and not very favorable maxillary anatomy.
We diagnosed an excessive maxillary display with not esthetically acceptable intra and inter teeth realationships.
Aesthetically she was bothered by the greyish show through cervically of her old PFM S as well.
We found that the incisal edge position and palatal anatomy of her PFMs could be improved for a better and balanced envelope of function.

Initial situation lower 1/3 smile & reatracted view

2. CBCT

3. Dental plan

4. Digital Smile Design

5. Designing the first fixed temporary bridge ( immediate post extractional temporary bridge , relined intraorally )

6. Extraction of the 4 upper incisors, bio oss , bio guide ( staged approach ),fixed provisional bridge relined on 14 13 24 23, new evaluation on CBCT after 4 months

7. Functional evaluation first provisional

8. Re evaluation of the challenging prostho surgical project with the dental laboratory

9. Communication with the dental laboratory of the challenges to overcome in the fixed prosthesis design ( screw retained yes/no,angulated screw chanel yes/no, cemented yes/no screwed substructure and cemented crowns yes/no , material choice etc)