Reabilitação protética após fratura dento-alveolar extensa – relato de caso

Abstract

Bucco-sinus communications are common incidences and may be associated with posterior superior tooth extraction. In large maxillary losses, repairing prostheses have a categorical or essential indication. Thus, the objective of this study is to report a clinical case of prosthetic rehabilitation using a removable partial denture (RPD) due to absence of teeth in the posterior maxilla region resulting from a dento-alveolar fracture as consequence of traumatic injury. A 21-year-old male patient attended the dental clinic at Nilton Lins University, reporting masticatory failure, discomfort and sensitivity when eating cold foods in the right upper molars region. After clinical and radiographic examination, it was observed that in addition to the absence of teeth 16, 17 and 18, there was an extensive bone loss in the right posterior hemiarch, with surgically sealed bucosinusal communication. As treatment plan, rehabilitation using a removable partial prosthesis modified and adapted to the acquired defect was proposed. In the consultations, the stages of study model manufacturing, assemble in a semi-adjustable articulator and delineation. The modification of the metallic frame consisted of a larger connector, like a wide palatal plate 10 mm long without relief on the palate, complemented by indirect twinned clamps and direct “T” type on tooth 15. The case was concluded with the steps of metal frame test, teeth assembly, teeth testing, acrylization and installation. The rehabilitation treatment by means of restorative PPR was satisfactory, as it was observed that after its installation, the patient showed extreme satisfaction with the result obtained, with an explicit improvement in chewing and swallowing.