Arpit Sikri

Abstract

Flabby ridge is defined as an excessive mobile soft or fibrous tissue on the superficial aspect of the residual alveolar ridge. It is usually a common clinical finding affecting the maxillary and mandibular edentulous ridges; in particular, the maxillary anterior region. It can be attributed to a number of reasons i.e. long-term denture wearers, natural teeth opposing an edentulous ridge etc. The treatment options or management of flabby ridges generally include a surgical and a non-surgical approach. The non-surgical approach involves the implant-retained prostheses and fabrication of conventional removable dentures using various modified impression techniques. Prosthetic management of the patients with flabby ridge is a testing situation for the prosthodontist. Although, retention, support, and stability are the important principles defining the success of the complete denture, the same can be affected in unconventional situations like flabby ridge. The incorporation of the conventional impression techniques may lead to an unstable and an unsatisfactory denture. Henceforth, various impression techniques have been proposed in literature to overcome such issues and recording the entire denture bearing area in function along with flabby tissue in an undisplaced form. This case report portrays an innovative and practical yet simple modified impression technique using the incorporation of a customized prefabricated metal mesh into the custom tray i.e. single step impression technique along with the polyvinyl siloxane impression material for managing and minimizing the displacement of a flabby ridge in the maxillary arch and ultimately ensuring a well-fitting prosthesis.   Keywords: Complete denture, Customized metal mesh impression tray, Displaceable tissue, Fibrous ridge, Flabby ridge, Hyperplastic tissue, Impression technique, Individual tray, Modified custom tray, Undisplaced tissue

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Abstract

Dentistry, in particular, the implant dentistry has always been through various leaps and bounds during the last decade. With the advent of various technologies in dentistry, one such cutting edge technology is the digital dental implantology. The digitization in the practice of dentistry; particularly, the dental implantology, is running swiftly and has tremendously helped in shaping the future of dentistry. Digital dentistry involves various digital tools/modalities/sources namely the CBCT (Cone Beam Computed Tomography), intraoral & extraoral (laboratory) scanners, facial scanners with the photogrammetry, CAD (Computer-aided design), CAM (Computer-aided manufacturing) and RP (Rapid prototyping) or 3DP (3D Printing), have influenced the implant practice in a big way. A very important component or heart of the digital implantology is termed as the digital workflow and is readily accessible in the implant practice. Such workflow has tremendously helped the dental practitioner to treat the patients using a stepwise approach at various stages i.e. diagnosis, scanning, designing, and final fabrication of the prosthesis. It has a plethora of advantages i.e. precise planning of the implant restorations associated with reduced complications and thereby ensuring long-term success of the dental implants. A number of issues to be importantly taken into account involve minor inaccuracies associated with the various digital tools, deviations i.e. linear and angular deviations between the planned and the placed implant position, and a steep learning curve, may lead to unsatisfactory results, if neglected. Digital workflows can be successfully integrated into the routine dental practices. This comprehensive review article portrays about the digital modalities & their meticulous usage in the practice of implantology for better accuracy, patient safety, and predictability associated with reduction in the errors and complications in implant practice.   Keywords: CAD, CAM, CBCT, Dental, Dental implants, Digital, Implantology, Scanners, Workflow

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Abstract

Prosthetic rehabilitation in patients having prominent labial ridge with conventional complete denture is an uphill task. Severe labial ridge undercuts are commonly seen incompletely edentulous maxilla than in mandible. This may be attributed to the fact related to the proclined maxillary anteriors, indicated for extraction. Treatment approaches generally involve either a surgical or a non-surgical option. The non-surgical or the prosthetic option generally involves the fabrication of conventional complete denture, which may further compromise the esthetics due to excessive thickness of the labial flange. To challenge such situations, an unconventional approach is needed for fabricating a complete denture. This case report delineates a simple, economical, conservative and non-surgical treatment approach for fabrication of denture in a patient with excessive bulky maxillary ridge, to pronounce the final facial aesthetics of the patient.   Keywords: Flangeless, Flangeless denture, Gumfit denture, Labial flange, Labial undercut, Open faced denture, Prosthodontics, Window denture

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