Case 7: Immediate FPD- the best option in achieving the emergence by creating ovate pontics in provisionals

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Case 7: Immediate FPD- the best option in achieving the emergence by creating ovate pontics in provisionals

Periodontially compromised situations requiring esthetic correcting is challenging. The proclination is accentuated to a greater extent and the periodontal status makes it a contra-indication for orthodontic alignment. Instead a diagnostic mock up was done to achieve retroclination for esthetic correction.



A diagnostic mock-up is done with ivory wax and considered an excellent method to discuss the details and the outcome of the treatment with the patient and the lab technician or the ceramist. Once finalised a putty index is made for the use and fabrication of provisionals post- extraction.

The sequence involves the preparation of tooth to receive the retainer of the FPD. In this case, I decided to fabricate 6-unit FPDs for maxillary and mandibular anteriors involving extraction of centrals and laterals in the lower and centrals in the maxillary arch. Firstly, we proceed with the crown preparation on the retainer teeth, followed by extraction of the severely proclined teeth under local anesthesia. Secondly, the putty index which was fabricated on the diagnostic mock-up is used for fabrication of an immediate bis-acryl provisionals.






Once the provisionals are in place, we leave the tissues to re-contour according to the ovate pontic created in the pontic segments. The provisionals are left in place for a span of 6 weeks before we go in for a definitive fixed prosthesis. In this case, the patient opted for a PFM bridge.



This case was done by me at Parasu Dental Hospital, Chennai.

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