title: Conservative and esthetic cast gold fixed partial dentures-inlay, onlay, and partial veneer retainers, custom composite pontics, and stress breakers: part II: utilization of additional retentive features and fabrication of custom pontic facings.
abstract: Although in today's dental world implant restorations are considered the standard of care in the replacement of missing teeth, clinical contraindications and patient nonacceptance of implant placement can be encountered. Several scenarios are discussed here in which a single missing tooth can be restored with conservative fixed partial dentures (FPD) that employ cast gold retainers; each with a customized design in order to preserve tooth structure, maintain esthetics, and provide a long-term prognosis. The abutment teeth are prepared for conservative partial coverage restorations by using Brasseler burs (Brasseler USA, Savannah, GA, USA). Impressions are taken of the preparations, along with any retentive features, utilizing either the Vented Pin Channel technique or the Shooshan Plastic Pin technique. The latter technique utilizes Kodex twist drills and corresponding impression pins (Coltene Whaledent Inc., Mahwah, NJ, USA). The conservative FPD with non-rigid connectors is fabricated by using type III gold alloy. The pontic cage portion is chemically prepared utilizing the Panavia F2.0 cement kit (Kuraray America Inc., Houston, TX, USA) or other dual-polymerizing resin cement and restored with any type of direct composite resin material. A palette of opaquers and tints are used for chairside characterization of the esthetic pontic facing. The final polish of the pontic is completed by using FlexiDisc and FlexiBuff discs (Cosmedent Inc., Chicago, IL, USA). CLINICAL SIGNIFICANCE In cases where an implant restoration is contraindicated for replacement of a single tooth, a semi-precision FPD is a conservative, functional, and esthetic alternative.
authors.affiliation: Division of Restorative Dentistry, UCLA School of Dentistry, 33-009A CHS, 10833 Le Conte Ave, Los Angeles, CA 90095-1668, USA. rstevenson@dentistry.ucla.edu
authors.forename: Richard G
authors.initials: RG
authors.lastname: Stevenson
authors.forename: Jane A
authors.initials: JA
authors.lastname: Refela
mesh_terms: D002484:Cementation / Q000379:methods; D003188:Composite Resins / Q000737:chemistry; D000044:Dental Abutments; D003734:Dental Casting Investment / Q000737:chemistry; D003761:Dental Impression Technique; D003764:Dental Materials / Q000737:chemistry; D003772:Dental Pins; D003775:Dental Polishing / Q000295:instrumentation; D003801:Dental Veneers; D003779:Denture Design; D003781:Denture Retention; D003830:Denture, Partial, Fixed; D004955:Esthetics, Dental; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D007284:Inlays; D017797:Prosthesis Coloring; D019279:Resin Cements / Q000737:chemistry; D019231:Tooth Preparation, Prosthodontic / Q000295:instrumentation / Q000379:methods
chemical_list: D003188:Composite Resins; D003734:Dental Casting Investment; D003764:Dental Materials; D006047:Gold Alloys; C438843:Panavia-Fluoro; D019279:Resin Cements