Year : 2021 Month : September Volume : 10 Issue : 36 Page : 3192-3195

Prosthetic Management of a Posterior Ridge Defect Case with Fixed Removable Type of Hybrid Prosthesis - A Case Report

Mallika S. Shetty1, Sanath Kumar Shetty2, Suhaim Sayyed Karkala3, Zahid Mohammed4, Tushar Milind Wankhede5

1, 2, 3, 4, 5 Department of Prosthodontics and Crown & Bridge,
Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India.

CORRESPONDING AUTHOR

Dr. Tushar Milind Wankhede, Department of Prosthodontics and Crown & Bridge, Yenepoya Dental College, Yenepoya University, University Road, Deralakatte, Mangalore-575018, Karnataka, India.
Email : tuushar18@gmail.com

INTRODUCTION

The main aim of prosthetic dentistry is restoring the form, function, comfort and appearance of the patient by the placement of a prosthesis replacing the missing teeth and contiguous tissues.1 Various prosthetic options for partially edentulous patients include an interim removable partial denture (RPD) to a cast partial denture, a fixed dental prosthesis (FDP), and a more implant-retained prosthesis.

However, FDP and implant-retained prosthesis are not always feasible, particularly in patients with excessive residual ridge resorption and jaw defects due to trauma and / or surgical ablation. In such a situation, a dentist may resort to another option of fixed-RPD prosthesis, to restore the defective hard and soft tissues to achieve natural aesthetics, phonetics, comfort, and better hygiene. This hybrid prosthesis fulfils the objectives of the rehabilitation such as support, stability, and retention characteristics similar to a fixed prosthesis and aesthetics and hygiene maintenance of a removable prosthesis.2,3,4,5

Any prosthesis designed or fabricated should be based on the prosthetic principles of support, stability, retention, and preservation of remaining structures.1 From the patient's perspective, retention is one of the important factors for its acceptability. These retentive options range from simple bar and clip attachments to more sophisticated spark erosion overdentures.6,7 Spark erosion prosthesis is technique sensitive, bulky, and requires expensive equipment.6,7 On the other hand, precision attachments provide better vertical support and stimulation to the underlying tissue through intermittent vertical massage.8

Treatment with a hybrid denture is an affordable choice to fulfil the patient's aesthetic demands along with providing a good prognosis for the prosthesis and preservation of the remaining dentition. This article presents two case reports of prosthodontic rehabilitation of a patient with mandibular defects using an attachment-retained fixed-removable hybrid prosthesis.

PRESENTATION OF CASE

A 23-year-old female patient reported to the Department of Prosthodontics, Yenepoya Dental College with multiple missing teeth in the mandibular right posterior region. History revealed that the patient had undergone surgery for chronic suppurative osteomyelitis present on the lower right posterior region of the jaw 8 months back, which resulted in a large hard and soft tissue deformity. Examination of maxillary arch revealed bilaterally missing 1st premolars and grossly decayed 2nd premolar of the right side (Fig.1). The remaining teeth were intact and in good periodontal condition. Mandibular arch examination revealed missing lower right canine, premolars, first molar and second premolar on the left side. (Fig.2). Grade 1 recession (According to Miller’s classification) was seen on the distal aspect of the lower right lateral incisor with a mesially tilted second molar. Radiographic examination revealed 20 % bone loss in relation to lower right lateral incisor without any clinical mobility. Considering the extent of the defect, a prosthesis that would restore the missing teeth, as well as the deficient part of the ridge, was planned.