Gingival cascade/ cosmetic dentistry training

GINGIVAL CASCADE (FACADE) : ANGINGIVAL CASCADE (FACADE) : AN
ESTHETIC SOLUTION IN DENTALESTHETIC SOLUTION IN DENTAL
PRACTICEPRACTICE
- A CLINICAL REPORT- A CLINICAL REPORT
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

INTRODUCTIOINTRODUCTIO
NN
 ““Beauty lies in the eyes of the beholder”.Beauty lies in the eyes of the beholder”.
 Dental esthetics is based on the “white component”Dental esthetics is based on the “white component”
(teeth ) and the “pink component” (the gingiva).(teeth ) and the “pink component” (the gingiva).
 Loss of alveolar ridge with several anterior teeth -Loss of alveolar ridge with several anterior teeth -
through surgery or periodontal bone loss.through surgery or periodontal bone loss.
 Poor esthetics and phonetics.Poor esthetics and phonetics.

There are three approachesThere are three approaches
to this problem:to this problem:
1) Anterior Fixed Partial Denture.1) Anterior Fixed Partial Denture.
2) A tooth borne Removable2) A tooth borne Removable
Partial Denture.Partial Denture.
3) “Andrews Bridge” - A3) “Andrews Bridge” - A
combination of abutmentcombination of abutment
retainers with bar suspendedretainers with bar suspended
between them and thebetween them and the
corresponding sleeve overlaidcorresponding sleeve overlaid
with acrylic resin denturewith acrylic resin denture
teeth and the gingiva.teeth and the gingiva.
Introduction…

 This clinical report describes the fabrication of aThis clinical report describes the fabrication of a
Gingival Cascade, by using a simple two stageGingival Cascade, by using a simple two stage
impression technique (buccal approach).impression technique (buccal approach).
Introduction…

CASE REPORTCASE REPORT
HistoryHistory:-Trauma that resulted in:-Trauma that resulted in
the loss of upper central andthe loss of upper central and
lateral incisors 3 years ago.lateral incisors 3 years ago.
ExaminationExamination :-:-
MissingMissing - 11, 12, 21 and 22.- 11, 12, 21 and 22.
PreparedPrepared - 13 and 23- 13 and 23
Deficient maxilla in the anteriorDeficient maxilla in the anterior
region.region.
A 53 years old male patient was referred to Dept. of
Prosthodontics, for prosthetic rehabilitation of missing
upper anterior teeth.

TREATMENT PLANTREATMENT PLAN
 Placement of twoPlacement of two
implants in 12 and 22implants in 12 and 22
region with four unit F.P.Dregion with four unit F.P.D
 Individual crowns for 13Individual crowns for 13
and 23and 23
 Gingival Cascade - fromGingival Cascade - from
heat cure acrylic material.heat cure acrylic material.
Case Report…

PROCEDUREPROCEDURE
A labial acrylic custom trayA labial acrylic custom tray
was fabricated on thiswas fabricated on this
diagnostic cast extending uptodiagnostic cast extending upto
the distal embrasure of the firstthe distal embrasure of the first
premolar, located on thepremolar, located on the
buccal cusp tips and thebuccal cusp tips and the
incisal edges only.incisal edges only.
Primary impression of the upper arch was made
using irreversible hydrocolloid impression material and
a diagnostic cast obtained.

 Palatal barrier : A silicone puttyPalatal barrier : A silicone putty
was mixed and molded on thewas mixed and molded on the
palatal aspect of teeth to bepalatal aspect of teeth to be
treated. After setting , this barriertreated. After setting , this barrier
was trimmed so that it preventswas trimmed so that it prevents
the final impression material fromthe final impression material from
escaping palatally withoutescaping palatally without
encroaching the interdentalencroaching the interdental
space.space.
 Final Impression was made byFinal Impression was made by
using a polyvinyl siloxaneusing a polyvinyl siloxane
impression material and poured inimpression material and poured in
artificial stone to get the workingartificial stone to get the working
model.model.
Procedure…

 Wax Pattern : The cascade wasWax Pattern : The cascade was
waxed up exactly as it has towaxed up exactly as it has to
appear and tried in the patientsappear and tried in the patients
mouth for its adaptation.mouth for its adaptation.
 The pattern was then flaskedThe pattern was then flasked
 Colors and stains were added atColors and stains were added at
the packing stage so as to get thethe packing stage so as to get the
desired characterizationdesired characterization
 It was processed in theIt was processed in the
conventional manner.conventional manner.
Procedure…

 The prosthesis was finished,The prosthesis was finished,
polished, and inserted in thepolished, and inserted in the
patient’s mouth.patient’s mouth.
 Instructions were givenInstructions were given
regarding the insertion andregarding the insertion and
removal of the prosthesis.removal of the prosthesis.
 No direct retention was requiredNo direct retention was required
as the musculature of the lipas the musculature of the lip
holds the prosthesis firmly inholds the prosthesis firmly in
place. The patient must manuallyplace. The patient must manually
raise the lip to remove theraise the lip to remove the
cascade.cascade.
Procedure…

BEFOREBEFORE AFTERAFTER

DISCUSSIONDISCUSSION
 Gingival defects - surgical or prosthetic approaches.Gingival defects - surgical or prosthetic approaches.
 SURGICAL TREATMENTSURGICAL TREATMENT - Successful only when small- Successful only when small
volumes of tissues are being reconstructed.volumes of tissues are being reconstructed.
Not popular because of cost, healing time, discomfort andNot popular because of cost, healing time, discomfort and
unpredictability.unpredictability.
 PROSTHETIC APPROACHPROSTHETIC APPROACH - removable or fixed- removable or fixed
prosthesis.prosthesis.
Different materials - Cold cure and heat cure acrylicDifferent materials - Cold cure and heat cure acrylic
materials, porcelain, as well as silicone based softmaterials, porcelain, as well as silicone based soft
materials.materials. www.indiandentalacademy.com

A FIXED PROSTHESISA FIXED PROSTHESIS – comfort, peace of mind and– comfort, peace of mind and
self confidence. Its use is limited to areas only whereself confidence. Its use is limited to areas only where
oral hygiene can be maintained.oral hygiene can be maintained.
SILICONE –SILICONE – Flexible Prosthesis:Flexible Prosthesis:
Limitations:-Limitations:-
1. Expensive.1. Expensive.
2. Accumulation of stains and plaque because of2. Accumulation of stains and plaque because of
inherent porosity of silicone material.inherent porosity of silicone material.
3.Possibility of ingestion of the prosthesis during3.Possibility of ingestion of the prosthesis during
function.function.
Discussion…

The described technique i.e. fabrication ofThe described technique i.e. fabrication of
Gingival Cascade by using heat cure acrylic resinGingival Cascade by using heat cure acrylic resin
material has several advantages:material has several advantages:
1. It is simple and inexpensive1. It is simple and inexpensive
2. It uses only conventional laboratory procedures2. It uses only conventional laboratory procedures
3. No complex attachments or bars involved3. No complex attachments or bars involved
4. Allows try in of the prosthesis at the wax pattern4. Allows try in of the prosthesis at the wax pattern
stage.stage.
Discussion…

CONCLUSIONCONCLUSION
A technique for restoring an anterior edentulousA technique for restoring an anterior edentulous
space accompanying severe alveolar bone loss hasspace accompanying severe alveolar bone loss has
been describedbeen described
This technique combines fixed and removableThis technique combines fixed and removable
restorations to achieve an acceptable esthetic andrestorations to achieve an acceptable esthetic and
functional results.functional results.
The technique described is relatively simple,The technique described is relatively simple,
inexpensive and hygienic.inexpensive and hygienic.
The cosmetic results achieved from this prosthesisThe cosmetic results achieved from this prosthesis
has enabled many patients to smile with confidence.has enabled many patients to smile with confidence.

Thank you…
For more details please visit

Gingival cascade/ cosmetic dentistry training

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Gingival cascade/ cosmetic dentistry training

Similar to Gingival cascade/ cosmetic dentistry training (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Gingival cascade/ cosmetic dentistry training