Diverse modalities of gingival replacement: A report of three cases
A 23-year-old male presented with missing maxillary right central and left central and lateral incisors and mandibular right and left central and lateral incisors along with loss of alveolar bone in a road traffic accident. The patient was more concerned about replacement of his lost teeth and he was not interested in any additional surgical procedure to reconstruct his lost tissue as he had already undergone other oral and maxillofacial surgical procedures. In accordance with the patient's wishes, a fixed prosthesis was planned in conjunction with the removable gingival replacement prosthesis. Even though an implant supported fixed prosthesis would have been a better choice considering the age of the patient, because of lack of adequate quantity and quality of bone and the cost factor, we had planned for a fixed prosthesis in conjunction with removable gingival replacement prosthesis. Root canal treatment was performed for right lateral incisor and canine in maxillary arch and right and left canines in mandibular arch as they had already become non-vital. The abutment preparations to receive a fixed prosthesis were done to right lateral incisor and right and left canines in maxillary arch and right and left canines and first premolars in mandibular arch. Impressions were made with Addition Silicone (Aquasil™ Soft Putty/Regular set and Aquasil™ LV Type 1 Low Viscosity). The fixed prosthesis was designed with undercuts in the interdental areas to retain the gingival replacement prosthesis []. An intraoral try-in of wax up of removable gingival prosthesis was accomplished. The patient found that the wax up significantly improved his aesthetics and his phonetic comfort. This wax-up was duplicated to form a removable prosthesis. As the patient had dark melanin pigmentation, we tried to incorporate the melanin pigment in the removable prosthesis to mimic his surrounding soft tissue. This removable prosthesis was relined with soft resilient liner from the intaglio surface to provide comfort during function [].