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Gingival cascade /certified fixed orthodontic courses by Indian dental academy


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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit ,or call

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Gingival cascade /certified fixed orthodontic courses by Indian dental academy

  1. 1. GINGIVAL CASCADE INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. INTRODUCTIO N  “Beauty lies in the eyes of the beholder”.  Dental esthetics is based on the “white component” (teeth ) and the “pink component” (the gingiva).  Loss of alveolar ridge with several anterior teeth through surgery or periodontal bone loss.  Poor esthetics and phonetics.
  3. 3. Introduction… There are three approaches to this problem: 1) Anterior Fixed Partial Denture. 2) A tooth borne Removable Partial Denture. 3) “Andrews Bridge” - A combination of abutment retainers with bar suspended between them and the corresponding sleeve overlaid with acrylic resin denture teeth and the gingiva.
  4. 4. Introduction…  This clinical report describes the fabrication of a Gingival Cascade, by using a simple two stage impression technique (buccal approach).
  5. 5. CASE REPORT A 53 years old male patient was referred to Dept. of Prosthodontics, for prosthetic rehabilitation of missing upper anterior teeth. History:-Trauma that resulted in the loss of upper central and lateral incisors 3 years ago. Examination :Missing - 11, 12, 21 and 22. Prepared - 13 and 23 Deficient maxilla in the anterior region.
  6. 6. Case Report… TREATMENT PLAN  Placement of two implants in 12 and 22 region with four unit F.P.D  Individual crowns for 13 and 23  Gingival Cascade - from heat cure acrylic material.
  7. 7. PROCEDURE Primary impression of the upper arch was made using irreversible hydrocolloid impression material and a diagnostic cast obtained. A labial acrylic custom tray was fabricated on this diagnostic cast extending upto the distal embrasure of the first premolar, buccal located cusp tips incisal edges only. on the and the
  8. 8. Procedure…  Palatal barrier : A silicone putty was mixed and molded on the palatal aspect of teeth to be treated. After setting , this barrier was trimmed so that it prevents the final impression material from escaping palatally without encroaching the interdental space.  Final Impression was made by using a polyvinyl siloxane impression material and poured in artificial stone to get the working model.
  9. 9. Procedure…  Wax Pattern : The cascade was waxed up exactly as it has to appear and tried in the patients mouth for its adaptation.  The pattern was then flasked  Colors and stains were added at the packing stage so as to get the desired characterization  It was processed conventional manner. in the
  10. 10. Procedure…  The prosthesis was finished, polished, and inserted in the patient’s mouth.  Instructions were given regarding the insertion and removal of the prosthesis.  No direct retention was required as the musculature of the lip holds the prosthesis firmly in place. The patient must manually raise the lip to remove the cascade.
  11. 11. BEFORE AFTER
  12. 12. DISCUSSION   Gingival defects - surgical or prosthetic approaches. SURGICAL TREATMENT - Successful only when small volumes of tissues are being reconstructed. Not popular because of cost, healing time, discomfort and unpredictability.  PROSTHETIC APPROACH - removable or fixed prosthesis. Different materials - Cold cure and heat cure acrylic materials, porcelain, as well as silicone based soft materials.
  13. 13. Discussion… A FIXED PROSTHESIS – comfort, peace of mind and self confidence. Its use is limited to areas only where oral hygiene can be maintained. SILICONE – Flexible Prosthesis: Limitations:- 1. Expensive. 2. Accumulation of stains and plaque because of inherent porosity of silicone material. 3.Possibility of ingestion of the prosthesis during function.
  14. 14. Discussion… The described technique i.e. fabrication of Gingival Cascade by using heat cure acrylic resin material has several advantages: 1. It is simple and inexpensive 2. It uses only conventional laboratory procedures 3. No complex attachments or bars involved 4. Allows try in of the prosthesis at the wax pattern stage.
  15. 15. CONCLUSION A technique for restoring an anterior edentulous space accompanying severe alveolar bone loss has been described This technique combines fixed and removable restorations to achieve an acceptable esthetic and functional results. The technique described is relatively simple, inexpensive and hygienic. The cosmetic results achieved from this prosthesis has enabled many patients to smile with confidence.
  16. 16. Thank you…