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Year : 2015  |  Volume : 3  |  Issue : 3  |  Page : 96

How does fixed prosthodontics interface with periodontology?

Department of Prosthodontics, College of Dentistry, Ziauddin University, Karachi, Pakistan

Date of Web Publication30-Oct-2015

Correspondence Address:
Dr. Haroon Rashid
Department of Prosthodontics, College of Dentistry, Ziauddin University, Karachi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-4619.168732

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How to cite this article:
Rashid H. How does fixed prosthodontics interface with periodontology?. J Res Dent 2015;3:96

How to cite this URL:
Rashid H. How does fixed prosthodontics interface with periodontology?. J Res Dent [serial online] 2015 [cited 2020 Apr 2];3:96. Available from: http://www.jresdent.org/text.asp?2015/3/3/96/168732

Sound periodontal foundation is essential for successful restorative therapy and the maintenance of healthy periodontium is essential for long-term success of prosthodontic restorations. This relationship is widely documented in the clinical dental literature.[1] Maintenance of periodontal health at the margins of crowns represents one of the tricky challenges for a restorative dentist and locating the margin of a restoration in relation to the alveolar bone height is one of the important parameters that will ensure long-term health of the gingiva.[2] Crowns and fixed partial dentures that may cause interference with the host defenses will create areas of microbial contamination, leading to bacterial biofilm formation and subsequent damage to the periodontium.[3]

The term used to describe the mucosal tissue contacting the teeth is biological width. It is defined as "the combined width of connective tissue and junctional epithelial attachment formed adjacent to a tooth and superior to the crestal bone."[4] It is of prime importance for the biological width to be maintained during crown preparations in order to avoid infiltration of bacterial toxins on the crest of the alveolar bone. Those subgingival restorations that cause encroachment of the junctional epithelium may lead to a damaging effect on the neighboring hard and soft tissues. In cases where longer clinical crown height is required, surgical crown lengthening with osseous recontouring may be recommended. Crown lengthening is the procedure that involves removal of the hard and soft tissues to achieve supracrestal tooth length.[5] However, it is recommended that the prosthetic phase of the treatment be started at least 3 months after crown lengthening so that the final vertical position of the tissues is well established.

Preservation and maintenance of healthy natural dentition is the ultimate aim in clinical dentistry. When multidisciplinary clinical treatment is initiated, it is logical that periodontal treatment precedes the final fabricated restorations. In order to achieve long-term clinical success for restorations, the periodontium should remain in a healthy state. This will only be possible if the final prosthesis is in harmony with the surrounding periodontal healthy tissues. With time, as the patients' need and demand increase, dental practitioners will surely be presented with those patients who require multidisciplinary treatment approaches. Cases may include emergency dental care, aesthetic rehabilitation, and prosthodontic and periodontal treatment that must ideally be done by skillful hands while maintaining the health of the residual dental and periodontal structures.

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  References Top

Gracis S, Fradeani M, Celletti R, Bracchetti G. Biological integration of aesthetic restorations: Factors influencing appearance and long-term success. Periodontol 2000 2001;27:29-44.  Back to cited text no. 1
Goldberg PV, Higginbottom FL, Wilson TG. Periodontal considerations in restorative and implant therapy. Periodontol 2000 2001;25:100-9.  Back to cited text no. 2
Kois JC. The restorative-periodontal interface: Biological parameters. Periodontol 2000 1996;11:29-38.  Back to cited text no. 3
The glossary of prosthodontic terms. J Prosthet Dent 2005;94:10-92.  Back to cited text no. 4
Hempton TJ, Dominici JT. Contemporary crown-lengthening therapy: A review. J Am Dent Assoc 2010;141:647-55.  Back to cited text no. 5


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