Questionable abutments: General considerations, changing trends in treatment planning and available options

Abstract

Abutment teeth are called upon to withstand the forces normally directed to the missing teeth, in addition to those usually applied to the abutments. Whenever possible, an abutment should be a vital tooth. Normally, teeth with active periodontal problem should not be used as abutment teeth. The use of multiple splinted abutment teeth, non-rigid connectors or intermediate abutments makes the procedure much more difficult and often the result compromises the long-term prognosis. In cases where tooth preparation cannot solve the problem, the use of various attachments and a telescopic retainer must be considered. Understanding the basic concepts of how to retain various restorative components and how to protect the remaining tooth structure, will enable us to answer the numerous questionable situations that arise during the restorative process will be facilitated. Thus, this will result in final restorations that are based on sound design principles.Clinical Relevance to Interdisciplinary DentistryFixed prosthetic treatments are always dependent upon the support they receive from abutment teeth. Abutment teeth should have sufficient coronal structure to provide retention to the prosthesis. It might sometimes be necessary to expose or increase the clinical crown by periodontal surgery for support and esthetics. It is also seen that many a times the teeth are supra erupted as a result of absence of opposing dentition which calls for the need of intentional endodontic treatment. By a combination of treatments with interdisciplinary dentistry, we will succeed in providing a functional prosthesis which fulfils esthetic and restorative needs.