Fig. 11
From: Rehabilitating a severely worn dentition with removable prosthodontics
Moderate generalised erosive tooth wear treated with same arch maxillary direct composite build-ups, resin-bonded bridge 22, 23 to replace 22 and definitive cobalt-chrome partial denture, and mandibular direct composite build-up restorations. The patient required an interim phase with acrylic partial denture before the definitive cobalt-chrome denture was constructed. a, b, c) Pre-operative views demonstrating erosive tooth wear in both arches, chipped existing composite restorations and failing Resin bonded bridge 22,23. d, e) Diagnostic wax-ups and maxillary partial denture wax-tooth try-in made on articulated study models mounted at the desired OVD on a semi-adjustable articulator. Note how the wax-tooth try-in has acrylic onlay rests on 26, 27 a to provide tooth support at the increased OVD. f, g, h) Aesthetic preview appointment with temporary crown and bridge material (Integrity, Dentsply Sirona) on teeth to have composite restorations, and wax-tooth try-in maxillary partial denture. i) Addition cured silicone (Memosil 2, Kulzer) full coverage indices made from diagnostic wax-ups. j) Palatal addition cured silicone guide used for direct composite build-up restorations, based on the confirmed diagnostic wax-up. k, l, m, n) Post-operative photographs following provision of definitive maxillary cobalt-chrome partial denture. The completed restorations were direct composite build-up restorations on 11, 12, 13, 21, 23, 31, ,32, 33, 41, 42, 43, resin-bonded bridge 22, 23, maxillary partial cobalt-chrome denture
