Natural Teeth Used in Immediate Removable Partial Denture: A Simple Solution

INTRODUCTION

Maxillary central incisors dominate the physical appearanceand add to the smile, esthetics and self-esteem of an individual1. For patients who are more esthetically demanding, patients own natural teeth may be used in removable partial denture. When extraction ofteeth is indicated, immediate denture enables the patient to engage in routine social activities without an embarrassing period of not having teeth2.
An immediate denture is any removable dental prosthesis fabricated for placement immediately following the removal of natural tooth/teeth3.However, if patient’s own natural teeth can be attached to his immediate denture, the cliniciancan easily overcome his expectations, thereby increasing his self-esteem and morale.This case report describes a technique using patient’s natural teeth in construction of immediate removable partial denture.

CASE REPORT

A Patient by name Oblesh aged 45 yrs came to department of Prosthodontics who complained of mobility of anterior tooth-11 & 21.Patient had no significant medical history.On clinical examination, tooth was found to be grade III mobile, (Fig 1) with localised Periodontitis& with poor prognosis.The treatment was planed&it was decided to extract 12 & 21(Fig 2)& replacement of the extracted teeth with immediate RPD incorporating patient’s own natural teeth.Patient was explained about limitations of the immediate denture and subsequent treatment required.

CLINICAL PROCEDURE

The upper & lower impression were made with irreversible hydrocolloid & cast was poured. The tooth to be replaced was removed from the cast and borders were rounded (Fig 3). The teeth were extracted (Fig 4) and was cleaned with saline & hydrogen peroxide.The teeth were decoronated (Fig 5)& dipped in sodium hypochlorite solution.Serration were made on the decoronated side.Using this decoronated natural teeth an immediate removable partial denture was made.(Fig 6) The rpd was trimmed & polish after the control of the bleeding.(Fig 7 & 8)After 24 hrs patient was recalled for further adjustment.

DISCUSSION:

The term biologic restoration was introduced by Santos and Bianchi in 1991. It is defined as an “alternative technique that uses adhesive capabilities of materials in combination with strategic placement of parts of human extracted teeth.
The technique of bonding tooth fragments was first proposed to repair permanent teeth with the patient’s own fractured crown [Chosak, 1964]. However, it also has been performed to restore crowns severely destroyed by carious disease, using fragments from another patient. Moreover, extracted permanent teeth have also been employed in removable and fixed prostheses.4 Natural crowns and roots, obtained from a tooth bank, have been used for several clinical and laboratory procedures.
The natural crowns offer outstanding anatomy and aesthetics as well as preservation of natural tooth color. The natural enamel has physiologic wear and offers superficialsmoothness and cervical adaptation compatible withthose of the surrounding teeth. However, the natural teeth will not last indefinitely asthey become brittle, and eventually they must be replaced.They can be considered as interim dentures. This procedure cannot be followed if local and systemic conditions are not ideal.5

CONCLUSION

Natural teeth will retain their hue and strength for a sufficient period to make their use practical in some instances .The use of patients own extracted natural teeth in theimmediate denture provided excellent esthetic advantage and added to the psychological well being of the patient. Due to the requirements of his lifestyle and employment thissort of immediate denture provided the most timely and efficacious replacement.

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