64 International Journal of Dentistry Research 2017; 2(3): 64-67 Case Report IJDR 2017; 2(3): 64-67 © 2017, All rights reserved www.dentistryscience.com *Corresponding author: Dr. Rani Ranabhatt Room no.305 D, Gautam Buddha Hostel, Chowk, Lucknow, Uttar Pradesh- 226003, India Tel. +917408385691 Email: ranikgdu08[at]gmail.com Open-faced maxillary overdenture: A simplified approach for enhanced esthetics Himanshi Aggarwal 1 , Rani Ranabhatt 2 , Niraj Mishra 3 , Pradeep Kumar 4 , Saumyendra Vikram Singh 5 1 M.D.S., Senior Reearch Fellow, Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University UP, Lucknow, Uttar Pradesh, India 2 M.D.S., Resident, Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University UP, Lucknow, Uttar Pradesh, India 3 M.D.S, Associate Professor, Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University UP, Lucknow, Uttar Pradesh, India 4 M.D.S., Senior Resident, Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University UP, Lucknow, Uttar Pradesh, India 5 Professor Jr Gr., Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University UP, Lucknow, Uttar Pradesh, India Abstract In partially edentulous patients, preservation of remaining teeth is of paramount importance. So, usually the remaining periodontally compromised teeth are preserved as overdenture abutments by reducing their coronal height. However, if this approach is adopted for anterior maxillary teeth, a prominent premaxillary segment poses challenges in terms of esthetics. This case report describes a modified approach for the management of a patient with extremely mutilated dentition having partially edentulous maxillary and mandibular arches. The maxillary anterior teeth were preserved as overdenture abutments resulting in prominent premaxilla, which was successfully rehabilitated using open faced denture that provided enhanced esthetics. Flangeless or open-faced denture exhibits promising results for rehabilitation of patients with prominent premaxilla without jeaopardising the peripheral seal along with superior esthetic outcome. It can serve as a valuable treatment modality as in cautiously selected cases. Keywords: Emergence profile, flangeless denture, Open faced maxillary overdenture, cast partial denture. INTRODUCTION Retention of roots to serve as overdenture abutments is a logical method of preventive prosthodontics. It offers several advantages from biologic as well as functional perspectives such as proprioception as well as reduced rate of ridge resorption [1] . Teeth with short clinical crowns, extensively mutilated and attrited dentition can be effectively used as overdenture abutments for removable prosthesis as preservation of remaining teeth is of utmost importance especially in cases of partial edentulism [3] . Muller Devan’s dictum (1952) has greatly stated that “The preservation of that, which remains is more important and not the meticulous replacement of what is lost”. However, it also poses several challenges for a clinician such as preservation of teeth in premaxilla usually results in a prominent labial fullness, thereby compromising esthetics. The maxilla often presents with a protruding trajectory before tooth extraction, producing the appearance of a protruding upper lip. In such cases, if the denture base extends upto the sulcus depth in premaxilla, two-third of the upper lip is severely distorted to meet aesthetic requirements besides providing ideal support to the upper lip. Additional retention may be availed by maintaining the undercuts in the premaxilla [3] . In such cases open faced or flangeless or gum fit denture may serve as a valuable treatment option [4] . This case report describes a modified approach for the management of a patient with extremely mutilated dentition having partially edentulous maxillary and mandibular arches where maxillary anterior teeth were preserved resulting in prominent premaxilla, which was successfully rehabilitated using open faced maxillary overdenture that provided enhanced esthetics.