View from the Chairside: Comprehensive Management of Restorative Endeavour of a Patient with a Cleft Lip and Palate
It is always a pleasure to welcome Dr. Paul Belzycki, general dentist from Toronto, who volunteered a number of clinical cases that will be presented on Oasis Discussions. Dr. Belzycki’s experience spans over 38 years of clinical practice in which he treated several complex cases that have required a combination of periodontal, endodontic, and prosthodontic treatments.
Dr. Belzycki shared his thoughts about the art and science of dentistry in a previous post that you can view by following this link.
I hope you find the case presentation valuable. Should you wish to ask Dr. Belzycki a question or to share your feedback, please do so by emailing us at firstname.lastname@example.org
Chiraz Guessaier, CDA Oasis Manager
In this case presentation, Dr. Paul Belzycki discusses one of his complex cases. As he progresses through his diagnosis and treatment plan, Dr. Belzycki explains in detail how he approached the various restorative challenges and issues that presented using his learned and acquired clinical skills.
The patient had extensive crown and bridge work that was functional and esthetic for quite a period of time, but presented with failed bridgework on the upper left and right. The first order of business was to retreat the endodontically-treated abutment teeth and place a provisional bridge.
At the next appointment, the temporaries were removed. The underlying tissues were inflamed and the margins extended deep into the gingival sulcus. Crown lengthening surgery was performed to achieve a better restorative outcome.
After a two-month period, the provisionals were removed. Amalgam core-buildups with pins were placed in #24 and cast post cores were fabricated for the central incisors and cuspids. Once the cast post cores were finalized and cemented permanently, another impression was taken for fabrication of the final prostheses. The first set of dies are separate metal copings which are tried in individually and high spots are adjusted, as needed. The metal copings were then luted together using acrylic powder/liquid. These copings are then fitted onto a second set of dies which are joined together using sticky wax and set in dental stone to fabricate a solder jig.
These extra steps ensure an accurate fit of the crown and bridge work for the patient.
Upon final insertion, the prostheses fit accurately with good, healthy tissues. After a 12-year follow-up period, the bridgework still has good esthetics and function and there has been minimal tissue rebound.
Full Case Presentation (31.24″)