Simplifying Accurate Adjustment of Proximal Contacts

Restoration of a partially edentulous mouth is only possible when the existing interarch space is sufficient enough to position artificial teeth for function and aesthetics.^1-4 With limited access to the posterior segment of the arch, an indirect evaluation based upon mounting of the study casts ensures correct assessment of the interarch distance, which requires multiple procedures.^5,6 Omission of this important step can lead to a critical error in designing and constructing either FPDs or RPDs.^3,4,6 When encountering problems with the lack of interarch distance while executing procedures of prostheses fabrication, patients’ misunderstanding may evoke the loss of trust and delay the entire time frame of construction.
The silicone bite registration material does not displace the mucosa in the edentulous area, sets fast, and is rigid and dimensionally stable. The processed material is sectioned either longitudinally along the crest of ridge or sagitally across the ridge at the site of interest. The thickness of the material is measured with a ruler or periodontal probe to determine the existing interarch distance and formulate possible treatment options in restoring the partially edentulous mouth. The early detection of the space at chairside enables the dentist to predict difficulties and complications related to further dental procedures and enhance patients’ understanding by visually demonstrating the available space as indicated by the thickness of the silicone index.
The patient presented in this article accepted a proposed treatment plan, which included extraction of teeth Nos. 14 and 15 (both extruded with furcation involvements) and restoration of the missing teeth (at Nos. 14 and 19 sites) with 2 individual metal ceramic implant restorations. The interarch space was divided to restore functions and aesthetics by constructing 2 opposing crowns and correcting the orientation of occlusal plane. The patient functions as normal at the one-year postinsertion as indicated by lack of gingival inflammation and stability of bony architecture around the dental implants