Case Report
Natural Tooth Pontic: An Instant Esthetic Option for
Periodontally Compromised Teeth—A Case Series
Rishi Raj, Kriti Mehrotra, Ipshita Narayan, Triveni Mavinakote Gowda, and D. S. Mehta
Department of Periodontics, Bapuji Dental College & Hospital, Davangere, Karnataka 577004, India
Correspondence should be addressed to Kriti Mehrotra; kriti1004@gmail.com
Received 26 July 2016; Accepted 30 October 2016
Academic Editor: Sukumaran Anil
Copyright © 2016 Rishi Raj et al. Tis is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease,
or endodontic failure. Te treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-
supported prosthesis, and implant-supported prosthesis. Irrespective of the fnal treatment, the frst line of management would
be to provisionally restore the patient’s esthetic appearance at the earliest, while functionally stabilizing the compromised arch.
Using the patient’s own natural tooth as a pontic ofers the benefts of being the right size, shape, and color and provides exact
repositioning in its original intraoral three-dimensional position. Additionally, using the patient’s platelet concentrate (platelet rich
fbrin) facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. Te abutment teeth
can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair
side thereby avoiding laboratory costs. Tis helps the patient better tolerate the efect of tooth loss psychologically. Te article
describes a successful, immediate, and viable technique for rehabilitation of three diferent patients requiring replacement ofa
single periodontally compromised tooth in an esthetic region.
1. Introduction
Esthetics and function of the orofacial region are very impor-
tant aspects of human life, which are afected by anterior
tooth loss regardless of personal factors such as age, gender,
and level of education, eventually impacting the quality of
life [1]. As dentists, we occasionally face daunting conditions
that warrant removal of teeth from a high esthetic zone
due to trauma, periodontal disease, root resorption, or failed
endodontic treatment [2]. Extraction of these teeth mainly
leads to esthetic and phonetic difculties and a functional
disability to some extent with pathologic migration. Mostly,
such patients either strongly desire to postpone the extraction
of their natural teeth or demand immediate management of
the esthetic crisis which could adversely afect their social life.
Conventional treatment options available include the
removable temporary acrylic prosthesis, resin bonded bridges,
and traditional metal and ceramic fxed partial denture
(FPD) and amongst the relatively newer options is osseointe-
grated implant-supported prosthesis [3]. Understanding the
patients’ cosmetic demands, functional needs, and afordabil-
ity becomes imperative in delivering the best possible dental
service.
In certain clinical scenarios, using an intact natural tooth
which is in good clinical condition as pontic for interim
duration could ofer a plethora of benefts like excellent color,
shape, and size match, positive psychological value, minimal
cost, and minimum chairside time with no laboratory pro-
cedure involved [4]. With recent advancements in adhesive
technology and the advent of newer and stronger composite
resin materials, it is possible to create a conservative, highly
esthetic prosthesis that is bonded directly to teeth adjacent to
the missing tooth.
Socket preservation, as a tool for optimizing the preser-
vation of the hard and sof tissue components of the alve-
olar ridge immediately following tooth extraction, has been
accepted as a clinical protocol for more than a decade now
[5]. Autologous platelet concentrates are claimed to enhance
hard and sof tissue healing due to the considerable amount
of growth factors that are released afer application in the
Hindawi Publishing Corporation
Case Reports in Dentistry
Volume 2016, Article ID 8502927, 6 pages
http://dx.doi.org/10.1155/2016/8502927