Clinical case-stidies: Cantilever Premolar - a minimally invasive approach by Dr J Van Rensburg
This is a case of a patient who has been without his UR5 for many years. He was not interested in extensive prosthodontic procedures but he would like the gap filled in.
Patient
Male,
Case history
The patient is male and 50 years of age. The patient lost the tooth long ago and is only concerned about the aesthetic aspect of the missing premolar. All treatment options were discussed and the patient requested me to do a fibre reinforced composite bridge to replace the missing tooth. This option was chosen because it is a minimally invasive technique and could be done in a single session. The fact that it is an economic option also influenced the patient in making the decision. Follow the pictures for a description of the procedure. The patient also requested me not to remove the amalgam filling from the UR6. Many times this makes sense.
Treatment
The fibre frame was constructed by bonding the everStick fibres to the UR4. An everStick C&B fibre on the buccal side and an everStick Perio fibre on the palatal side. This provided a strong frame onto which a composite pontic cuold be build up. Gradia Ao3 and A3 were used and the pontic was build up directly in the mouth agains the rubber dam
Pre-operative . Missing Upper second premolar
Occlusal view
The Fibre frame
End Result
Palatal view – End Result. Note that the occlusal table of the pontic is much smaller. This is to reduce the occlusal chewing forces on the cantilever pontic. The pontic is more for aesthetic reasons.
