REVIVING YOUR PORCELAIN SMILE: A GUIDE TO INTRAORAL REPAIR OF FIXED PORCELAIN PARTIAL DENTURES: A LITERATURE REVIEW

Background: Even though porcelain fused to metal (PFM) crown is the golden standard in dentistry, it still has a major disad-vantage, such as unaesthetic metallic seen. Resolving those type of problems, an all-ceramic restoration was chosen to improve aesthetic outcome especially in the anterior regions of the mouth. Objective: This article reports the replacement of old PFM crowns in central incisors with poor design with lithium disilicate crowns. Case: A 25-years-old female came to Prosthodontic Clinic RSKGM Universitas Indonesia with complaints of chipping PFM crowns in central incisors with poor shape and colour. Conclusion: Patient’s aesthetic expectations were successfully met through selection of lithium disilicate crowns.

Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM) and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM) individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

The clinical and laboratory steps involved in rehabilitating the maxillary arch following the loss of several teeth due to periodontal disease are outlined in this case report. This article illustrates the use of a laboratory based CAD/CAM system (Sirona In-Lab) and a copy milling technique in the fabrication of a fixed-movable bridge, high strength, all-ceramic, cross-arch bridge. Adopting a semi-fixed approach in cross-arch rehabilitation has conventionally involved the use of porcelain fused to metal (PFM) components but the demands placed by patients and clinicians have led to the development of novel techniques in order to achieve highly aesthetic and functional results.

Porcelain fused to metal (PFM) bridge is the most of treatment that commonly used as a fixed partial dentures. One of the indication for PFM bridge is to replacing the loss of posterior teeth. This case report discussed about the treatment of posterior missing teeth with PFM bridge. Objective: to explain the clinical procedures of PFM bridges to treat the patient with posterior missing teeth. Case report: A 29-years old woman came to prosthodontic clinic in Faculty of Dentistry University of Padjadjaran with chief complaint of right maxillary posterior missing teeth. The treatment planning that have been choosen for this case was the porcelain fused to metal bridge due this excellent characteristic of resistence to mastication force compared with other types of bridge such as all ceramic or all acrylic bridge. Beside that, the aesthetic achievement of this kind of bridges is more excellent than all metal bridges. Disscussion: A spatial analysis, calculation the number of abutment against which used, and selected design bridge very determine the success of this treatment. In addition to that, the clinical procedures consisting of abutment teeth preparation, an accurate impression, and appropriate cementation were needed to get the satisfactory result. Conclusions: The porcelain fused to metal bridge is a appropriate option for posterior missing teeth treatment that fullfil satisfactorical biomechanical and esthetic factors.

Full-mouth implant-supported prosthetic rehabilitation for failing dentition is a complex, multifactorial process influenced by prosthetic materials and peri-implant periodontal health. Traditionally, porcelain-fused-to-metal (PFM) frameworks have ensured functional stability and acceptable esthetics; however, the advent of monolithic zirconia layered with porcelain has introduced enhanced mechanical strength and esthetic appeal. This retrospective case series evaluated the 3-year clinical outcomes of full-arch implant-supported prostheses fabricated using either monolithic zirconia or PFM in edentulous patients, focusing on peri-implant soft-tissue health, marginal bone loss, and prosthetic complications. Ten edentulous patients rehabilitated with full-arch implant-supported prostheses were included and assessed clinically and radiographically for peri-implant tissue health, plaque accumulation, probing depth, bleeding on probing, marginal bone levels, and technical complications over a 3-year follow-up. Both prosthetic materials demonstrated stable peri-implant tissue health and 100% implant survival at the 3-year mark. Monolithic zirconia restorations exhibited reduced plaque accumulation, stable bone levels, and absence of prosthetic complications, whereas the PFM group showed minor technical issues such as porcelain chipping and screw loosening. Within the limitations of this study, both materials proved clinically viable for full-arch implant rehabilitation; however, monolithic zirconia showed a trend toward superior biological and mechanical outcomes. Larger, prospective studies are warranted to validate these preliminary findings.

Background: In dentistry, provisional fixed prosthodontic materials are essential because they act as temporary restorations that preserve prepared teeth, retain their aesthetic appeal, and ensure their proper function until the final prosthesis is made. Colour stability refers to the ability of a material to maintain its original colour over time, despite exposure to various environmental factors. The aim of this study is to assess how brushing simulation affects the colour stability of two types of provisional fixed prosthodontic materials. Materials and Methods: Ten disc-shaped specimens (10 mm diameter, 2 mm height) from Ivoclar and AVUE T Crown (five each) were prepared to evaluate colour stability. Using a brushing simulator (ZM3.8 SD Mechatronik), samples underwent 10,000 brushing cycles (2 hours) with Dabar Red Herbal toothpaste. Colour measurements were taken before and after brushing with a Konica Minolta CM5 spectrophotometer, and Delta E values were calculated. Paired t-tests in SPSS version 23 compared pre- and post-brushing colour stability, with results tabulated. Results: The study evaluated the colour stability (ΔE) of Ivoclar and AVUE T Crown provisional materials under simulated brushing. Ivoclar samples had minimal colour change (average ΔE 0.716), indicating good stability. AVUE samples showed significant colour shifts (average ΔE 6.498). The statistically significant p-value of 0.04 highlights the impact of brushing on colour stability, stressing the need for durable materials in routine oral hygiene. Conclusion: This study demonstrates that Ivoclar materials exhibit superior colour stability compared to AVUE materials, maintaining clinically acceptable ΔE values under simulated brushing conditions. These findings underscore the importance of selecting materials that resist colour change, ensuring aesthetic integrity and patient satisfaction in temporary dental restorations

Chipping is the most common complication in zirconia-supported porcelain prosthesis. If the prosthesis has ideal adaptation and there is no problem other than chipping, intraoral repair is the most practical solution for such failures. Composite resins are often preferred for intraoral porcelain repair. However, the wear and unstable colour of composite resins negatively affect aesthetics. This complication could be restored intraorally and aesthetically with ceramic veneer. This case report presents the intraoral repair of a zirconia supported Fixed Partial Denture (FPD) consisting of four units. The cohesive fracture of the ceramic material in the incisal part of maxillary right central incisor was restored with ceramic veneers. Preparation was done with a tapered, rounded end diamond bur under water-cooling. The impression was taken with elastomeric impression material. Ceramic veneer was manufactured with a leucite-reinforced glass-ceramic and cemented with light cure resin cement. Based on the three-year follow up of the performed intraoral repair, ceramic veneers have shown to be an alternative treatment for fractured FPD.

Background: Fracture or chipping of veneering ceramic resulting in aesthetic and functional issues is a frequent technical complication encountered with fixed dental prostheses. Treatment options include extraoral or intraoral repair of the ceramic restoration; the latter being minimally invasive and cost-effective. We reviewedthe various intraoral repair techniques for ceramic fractures and their efficiency in the last decade. Methods: A literature search was carried out between 2017 and 2022 using the PubMed database with keywords: intraoral, repair, ceramics, porcelain, and 'porcelain fused to metal'. Screening of abstracts and full texts was carried out to determine the final list of eligible studies. Results: Twenty-one eligible studies were included in the review which consisted of 17 in vitro studies, three case reports, and one prospective clinical study. Researchers and dentists preferred repairing cracked veneered zirconia-based restorations intraorally if the restoration is in acceptable condition. However, successful intraoral repair of veneering fractures relies on the bond between the previous restoration and the new repair material, the right adhesive resin, and adequate surface conditioning. The review indicated that the best technique to fix chipping in a complex made of zirconia core and veneering ceramic is to treat the veneering ceramic with hydrofluoric acid before covering the core ceramic with silica. Conclusion: Intraoral repair is an efficient and economic procedure without the need for repeated sessions. However, the success and longevity of the restoration rely on the technical skills of the clinicians and adherence to prescribed protocols.

Deficient bone is an impediment for implant placement in many patients. In this case report a patient reported with missing teeth in mandibular left back teeth region. The alveolar bone was severely resorbed with reduced occlusal clearance making prosthetic restoration with implants impossible. The objective here was bone regeneration and placement of implants in the area for restoration of function. A resorbable collagen membrane along with mineralized freeze dried bone grafting was used to gain alveolar ridge. After seven months two implants were placed following the delayed protocol achieving a good primary stability. Implant uncovering was carried out after five months with placement of a gingival former. This was followed by placement of a 2-unit crown in Porcelain fused to metal (PFM) which helped the patient in mastication. Thus alveolar ridge regeneration followed by implant placement is a viable treatment option provided the clinical scenario is ideal.

The mission and aim of Clinical Case Reports “…is to use clinical case reports to disseminate best clinical practice, to examine important common as well as uncommon clinical scenarios, and to illustrate and inform the use of important clinical guidelines and systematic reviews” http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2050-0904/homepage/ForAuthors.html. From this statement, it is clear that to be considered for publication in Clinical Case Reports, not all reported cases need to be unusual or uncommon. However, all do need to have a key clinical message – that is; all need to have a clear statement about the important lesson learned or significant information revealed through this particular clinical case. At Clinical Case Reports, we consider the key clinical message to be a very important part of the case report. It should summarize the central, take-home clinical message authors are seeking to impart in writing up and looking to publish their report. The key clinical message is intended to capture and reflect the crucial and central meaning of each case report. While there are some similarities with a traditional abstract, the key clinical message is more focused and concise, and does not contain the same amount of background information. At Clinical Case Reports, we require that the key clinical message of the report is summarized into a maximum of 50 words. This key clinical message has several important functions. Its major role to capture and reflect the crucial and central meaning of each report. It also in a sense justifies why the case report is worthy of being published; why it is that authors think the case they are reporting might be useful for others to read – or, to answer the question ‘what is it that other clinicians can learn from this case?’. Once the report is accepted for publication in Clinical Case Reports, this short (but informative) key message appears in the table of contents of the journal. In reading the key clinical message, readers should be able to grasp the value or importance of the paper and make a decision about whether or not this particular report might be useful for them. In addition, the key clinical message can help authors to decide what details of a case should and should not be included in the case report. The Clinical Case Reports author guidelines highlight that while the reporting of the case should be sufficiently detailed to explain the case, extraneous information should not be included. Therefore, if particular information is not relevant to the key clinical message, then it should not be included in the published case report. When preparing a key clinical message as part of a case report for submission to Clinical Case Reports, it can be helpful to browse through some of the published case reports on the Clinical Case Reports website, to see how other authors have presented their key clinical messages. During submission of the case report, the key clinical message should be entered in the ‘abstract’ field of the Clinical Case Reports submission site.

Introduction: Anterior implant placement is always challenging, especially when it is caused by trauma. Treatment preference is not only because of bone sufficiency but also aesthetic considerations. The complications aggravated by trauma and temporomandibular joint disorder need particular emphasis. The aim of this case report is to describe a new insight into dental implant treatment for trauma-induced edentulism and associated temporomandibular joint disorders. Case report: A 24-year-old woman had a motor vehicle accident. Her four anterior mandibular teeth were extracted through fractures. The patient also complained of clicking in both jaws during mouth opening. A bone graft and modification provisoris-stabilization splint were applied before definitive treatment. Furthermore, a 4-unit Porcelain Fused to Metal (PFM) implant-supported-fixed partial denture was done to replace the missing teeth. Conclusion: New insight into dental implant treatment for trauma-induced edentulism and associated temporomandibular joint disorders with replacement of several anterior mandibular missing teeth due to trauma with temporomandibular disorders could be treated with dental implant modification splint that functions as a temporary restoration as well, which was an alternative treatment option. The patient was satisfied with the result of the treatment, especially in the aesthetic aspect.KEYWORDSdental implant, trauma, temporomandibular joint disorders, splint

The long-term clinical performance of restoration in endodontically treated teeth (ETT) is an essential yet complicated strategy to achieve it. A resin-build-up tooth with higher elastic moduli is a minimally invasive strategy to decrease the risk of catastrophic root fracture. Additionally, intracanal resin composite anchorage simplifies the restorative procedure and increases the bonding. Objective: This case report describes a resin-build-up tooth restoration using the direct monoblock concept to replace a failed metal post and core and porcelain fused to metal (PFM) crown on the maxillary right central incisor. Case report: A 50-year-old man attended a dental university hospital with a chief complaint about the repeated detachment of the old resin-veneered crown along with the metal post on his maxillary right central incisor. He has been using that aged restoration for five years. The measurement of crown preparation in thickness was 2 mm, core length was 9 mm, post length was 7 mm, remaining gutta-percha was 5 mm, and the length from the end of gutta-percha to the apex was 1 mm. A Direct monoblock restoration using flowable and packable resin composite with universal adhesive was chosen to save time and to achieve long-term bonded restoration. Conclusion: Endodontically treated teeth on the maxillary incisor were successfully restored using the resin-build-up direct monoblock concept. The adhesive intracanal resin composite anchorage to a depth of 7 mm using a flowable resin composite replaced the post for ETT with favorable results. Moreover, the four-year follow-up of the clinical examination and evaluation showed good results.

Recent advancements in digital technologies have transformed clinical workflows in dentistry, ensuring precise restorations. Custom-made crowns and fixed partial dentures (FPDs) now rely on virtual articulation. The digital facebow provides individualized data for CAD settings, streamlining the fabrication via digital workflow. For the purpose of demonstrating the differences observed during fabrication, we present a case report involving a 68-year-old patient seeking a replacement for missing teeth 24, 25, 26, and 27. The treatment plan involved the fabrication of an implant-supported FPD using monolithic zirconia (ZrO2). However, technical hurdles emerged during the planning phase, primarily due to spatial limitations posing a risk of mechanical failure over time. Consequently, we pivoted approach towards a porcelain fused to metal (PFM) FPD. For the PFM FPD, individual values from the digital facebow adjusted both virtual and conventional articulators. For comparison, two ZrO2 FPDs were milled-individual settings and average settings. All restorations underwent assessment for occlusion in maximal intercuspal position and eccentric mandible movements. In conclusion, the case report showed that individualized PFM FPD required minimal adjustments compared to milled ZrO2 restorations, whether using individual or average values. Utilizing individual values from the digital facebow reduced operator working time and minimized the intraoral adjustments.

This is a case report presenting a female patient in her twenties suffering from severely stained, unaesthetic, and worn-out teeth since her childhood. It was a major aesthetic and functional concern for her. This clinical presentation describes the prosthetic rehabilitation of a patient with generalized discolored and worn-out teeth to have enhanced aesthetics and masticatory function of the patient. This is a referred case of dentinogenesis imperfecta- II (DGI-II) from the Department of Oral Medicine and Radiology and Oral Pathology, as diagnosed by them after a thorough clinical, radiographical, and histopathological examination. DGI is a disorder of teeth characterized by discoloration and rapid wear and belongs to a group of disorders of the development of teeth. Due to the rapid wear and generalized intrinsically stained and discolored teeth, there is a loss of vertical dimension of occlusion (VDO) and an unesthetic look of the patient respectively. Therefore, the main objective of the case report is to re-establish the aesthetic and regain the VDO and functionality of the damaged teeth using the Pankey Mann Schuyler philosophy in which the first anterior teeth were rehabilitated with porcelain fused to metal (PFM) crowns based on aesthetics and phonetics of the patient. This was followed by posterior PFM crowns based on Broadrick's flag analysis for posterior occlusal plane determination and centric occlusion.

Sjögren's syndrome is a chronic, inflammatory autoimmune disorder characterized by lymphocyte infiltration of the exocrine glands. Notably, the rehabilitation of partially edentulous patients with Sjögren's syndrome is limited by the scarce availability of studies that could inform therapeutic modalities and potential challenges during clinical procedures. This case report aimed to present the oral rehabilitation of a patient with Sjögren's syndrome who received fixed partial dentures (FPDs).A 28-year-old female patient sought treatment to restore her missing teeth. She was diagnosed with Sjögren's syndrome by a rheumatologist adhering to the revised version of the European criteria proposed by the American-European Consensus Group and was on a medication regimen including prednisolone, hydroxychloroquine, pantoprazole, pilocarpine, and tear substitutes to manage her condition.The final treatment plan consisted of extractions, management of gingivitis, post-and-core restorations, and a 2 mm vertical dimension increase with the placement of 15 porcelain-fused-to-metal (PFM) crowns and 4 short-span bridges. The patient underwent regular clinical and radiographic evaluations every 3 months since June 2020. Throughout this period, the fixed prostheses, teeth, and periodontal tissues demonstrated remarkable stability and exhibited no complications.This three-year case study provides evidence that meticulous planning and clinical execution can facilitate successful oral rehabilitation in young edentulous patients with Sjögren's syndrome. Tooth-supported fixed prostheses can effectively restore oral function and aesthetic appeal in these individuals, provided they undergo more frequent dental examinations than the general population and maintain a cooperative attitude throughout the treatment process.