Many times a dental practitioner comes across a situation where his clinical dexterity and knowledge can make the difference between a patient being delivered a removable or a fixed prosthesis. One such clinical situation is existence of a pier abutment in between two edentulous areas. Managing such a partial edentulous situation with a fixed partial denture can be successfully accomplished by those who understand basic principles of using a non-rigid connector, custom made in the laboratory. Clinical application of mandibular movements on the occlusal anatomy of artificial crowns is an essential component in such cases besides adequate education and motivation of the patient. This article in the form of a clinical case report describes the management of pier abutment case over a period of 5 years with a fixed movable prosthesis. A custom made design in the laboratory allows the pier abutment to support two different prostheses on either side, without undergoing any retentive or biological failure of the abutment. Moreover the flexible design also allows the patient to benefit from fixed prosthesis rather than a conventional removable prosthesis.
| [1] | Johnston JF, Phillips RW and Dykema RW. Modern Practice in Crown and Bridge Prosthodontics Ed. 2, Philadelphia 1965; W. B. Saunders Company:5-6. |
| [2] | Wilson WH and Lang RL. Practical Crown and Bridge Prosthodontics, New York. 1962; McGraw-Hill Book Company, Inc: 85-86 |
| [3] | Shillingburg HT, Hobo S, Whitsett LD, Jacobi R, Brackett SE. Fundamentals of fixed prosthodontics. 3rd Ed. Chicago. Quintessence; 1997: 85-103 |
| [4] | Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed Prosthodontics. 3rd Ed. St. Louis: Elsevier; 2000: 46-64. |
| [5] | Carr AB, McGivney GP, Brown DT. McCracken’s removable partial Prosthodontics. 11th Ed. St. Louis: Elsevier; 2004: 189-229. |
| [6] | Nyman SR, Lang NP. Tooth mobility and the biological rationale for splinting teeth. Periodontal 2000, 1994; 4: 15-22.View Article |
| [7] | Sorensen JA, Martinoff JT. Endodontically treated teeth as abutments. J Prosthet Dent 1985; 53: 631-636.View Article |
| [8] | Goodacre CJ, Spolnik KJ. The prosthodontic management of endodontically treated teeth: a literature review. Part I. Success and failure data, treatment concepts. J Prosthodont 1994; 3: 243-50.View Article PubMed |
| [9] | Savion I, Saucier CL, Rues S, Sadan A, Blatz M. The pier abutment: a review of the literature and a suggested mathematical model. Quintessence Int. 2006 May; 37 (5): 345-352. PubMed |
| [10] | Markley K. Broken-Stress ‘Principle & design in fixed bridge prosthesis. J Prosthet Dent 1951; 1: 416-423.View Article |
| [11] | Adams JD. Planning posterior bridges. J Am Dent Assoc 1956; 53:647-654. PubMed |
| [12] | Standlee JP, Caputo AA. Load transfer by fixed partial denture with three abutments. Quintessence Int 1988; 19:403-410. PubMed |
| [13] | Gill JR. Treatment planning for mouth rehabilitation. J Prosthet Dent 1952; 2: 230-45.View Article |
| [14] | Oruc S, Eraslan O, Tukay HA, Atay A. Stress analysis of effect of non-rigid connectors on fixed partial dentures with pier abutments. J Prosthet Dent 2008; 99: 185-92.View Article |
| [15] | Savion I, Saucier CL, Rues S, Sadan A, Blatz M. The pier abutment: A review of literature and suggested mathematical model. Quintessence Int 2006; 37: 345-52. PubMed |
| [16] | Sutherland JK, Holland GA, Sluder TB, Whie JT. A Photoelastic stress analysis of stress distribution in bone supporting fixed partial dentures of rigid & nonrigid designs. J Prosthet Dent 1980; 44: 616-23.View Article |
| [17] | Selcuk Oruc, Arzu Atay. Stress analysis of effects of nonrigid connectors on fixed partial dentures with pier abutments. J Prosthet Dent 2008; 99: 185-92.View Article |
| [18] | Russell D Nishimura, et al. Photoelastic stress analysis of load transfer to implants and natural teeth comparing rigid and semi rigid connectors. J Prosthet Dent 1999; 81: 696-703.View Article |
| [19] | Botelho MG, Dyson JE. Long-span, fixed-movable, resin-bonded fixed partial dentures: A retrospective, preliminary clinical investigation. Int J Prosthodont 2005; 18: 371-6. PubMed |
