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Prosthetic treatment of floating premaxilla: report of case
Prosthetic treatment of floating premaxilla: report of case
Phill Asrican, DDS, Pleasanton, Calif.
A prosthesis was fabricated fo r a 20-year-old man w ith a premaxilla displaced lingually to the con tour of the arch that was V-shaped. Complete pros thetic treatm ent is described. ¿Si'
A 20-year-old m an was exam ined at the dental clinic to determ ine a course o f treatm ent for a floating prem axilla (Fig. 1). T h e prem axillary process is separated from the lateral m axillary process as a result o f bilateral clefts and alveolar process and cleft o f the hard and soft palates (Fig. 2). The prem axillary process is attached to the nasal sep tum above. T h e patient was in good health generally and had a record o f the usual childhood diseases. His m other, father, two sisters, and one b ro th er were in good health, and there was no history o f other clefts in the family. N um erous corrective and cosm etic surgical pro cedures had been perform ed in various institutions from im m ediately after birth until 1965. C linical exam ination revealed the prem axilla
Fig. 1
■ Anterior view of floating premaxilla,
Fig. 2 ■ Premaxilla is unattached to lateral maxillary process. Note missing lateral incisor. 99
Fig. 3 ■ Central incisors removed. Cast gold copings fitted over prepared abutment teeth as foundation for removable upper partial denture.
displaced lingually to the contour o f the arch that was V -shaped. T h e perm anent teeth present were the 2 central incisors. T hey w ere mobile. T h e m o lars w ere in contact, but there was an angulated, anterio r open bite. T h e left canine and lateral teeth w ere missing, and there was no uvula. C om plete diagnostic records w ere made, includ ing study casts, bitew ing radiographs, periapical radiographs, and Panorex radiographs. All o p er ative work, extractions, and a com plete prophy laxis w ere done before beginning prosthetic treatm ent.
P ro sthe tic tre a tm e n t T h e left canine and right first prem olar were p re pared for cast gold copings fitted over the abutm ent
Fig. 5 ■ Labial view of prosthesis in place as immediate restoration.
teeth to be used as a foundation for the rem ovable partial upper denture (Fig. 3). A cobalt-chrom e one-piece casting was used for the partial denture. Plastic flanges w ere tinted to m atch the patient’s gingiva. T hese plastic flanges were p art o f the rem ovable partial denture. T he m obile central incisors were extracted in the usual m anner with the patient under local anes thesia (Fig. 3). T he partial upper denture was in serted im m ediately after extractions (Fig. 4). Tw o unilateral lower one-piece castings, replac ing the right and left first m olars, were also fabri cated. Onlays, part of the castings, w ere used to obtain a satisfactory and uniform occlusion (Fig. 4) Figure 5 is a labial view o f the prosthesis in place as an im m ediate restoration.
C onclusion T h e appliance was well fabricated, com fortable, easy to insert, and easy to remove. T he basic re quirem ents o f function, occlusion, and esthetics were successfully achieved. T here was a significant im provem ent in the patient’s speech and ap p ear ance.
Fig. 4 ■ Occlusal view of partial upper denture and lower right and left unilateral castings and onlays.
100 ■ JADA, Vol. 76, Jan. 1968
Doctor Asrican is dental director, Parks Job Corps Cen ter, Pleasanton, Calif. 94566
Phill Asrican, DDS, Pleasanton, Calif.
A prosthesis was fabricated fo r a 20-year-old man w ith a premaxilla displaced lingually to the con tour of the arch that was V-shaped. Complete pros thetic treatm ent is described. ¿Si'
A 20-year-old m an was exam ined at the dental clinic to determ ine a course o f treatm ent for a floating prem axilla (Fig. 1). T h e prem axillary process is separated from the lateral m axillary process as a result o f bilateral clefts and alveolar process and cleft o f the hard and soft palates (Fig. 2). The prem axillary process is attached to the nasal sep tum above. T h e patient was in good health generally and had a record o f the usual childhood diseases. His m other, father, two sisters, and one b ro th er were in good health, and there was no history o f other clefts in the family. N um erous corrective and cosm etic surgical pro cedures had been perform ed in various institutions from im m ediately after birth until 1965. C linical exam ination revealed the prem axilla
Fig. 1
■ Anterior view of floating premaxilla,
Fig. 2 ■ Premaxilla is unattached to lateral maxillary process. Note missing lateral incisor. 99
Fig. 3 ■ Central incisors removed. Cast gold copings fitted over prepared abutment teeth as foundation for removable upper partial denture.
displaced lingually to the contour o f the arch that was V -shaped. T h e perm anent teeth present were the 2 central incisors. T hey w ere mobile. T h e m o lars w ere in contact, but there was an angulated, anterio r open bite. T h e left canine and lateral teeth w ere missing, and there was no uvula. C om plete diagnostic records w ere made, includ ing study casts, bitew ing radiographs, periapical radiographs, and Panorex radiographs. All o p er ative work, extractions, and a com plete prophy laxis w ere done before beginning prosthetic treatm ent.
P ro sthe tic tre a tm e n t T h e left canine and right first prem olar were p re pared for cast gold copings fitted over the abutm ent
Fig. 5 ■ Labial view of prosthesis in place as immediate restoration.
teeth to be used as a foundation for the rem ovable partial upper denture (Fig. 3). A cobalt-chrom e one-piece casting was used for the partial denture. Plastic flanges w ere tinted to m atch the patient’s gingiva. T hese plastic flanges were p art o f the rem ovable partial denture. T he m obile central incisors were extracted in the usual m anner with the patient under local anes thesia (Fig. 3). T he partial upper denture was in serted im m ediately after extractions (Fig. 4). Tw o unilateral lower one-piece castings, replac ing the right and left first m olars, were also fabri cated. Onlays, part of the castings, w ere used to obtain a satisfactory and uniform occlusion (Fig. 4) Figure 5 is a labial view o f the prosthesis in place as an im m ediate restoration.
C onclusion T h e appliance was well fabricated, com fortable, easy to insert, and easy to remove. T he basic re quirem ents o f function, occlusion, and esthetics were successfully achieved. T here was a significant im provem ent in the patient’s speech and ap p ear ance.
Fig. 4 ■ Occlusal view of partial upper denture and lower right and left unilateral castings and onlays.
100 ■ JADA, Vol. 76, Jan. 1968
Doctor Asrican is dental director, Parks Job Corps Cen ter, Pleasanton, Calif. 94566