International Dentistry - Vol. 12, No. 2 - 4

CASE REPORT

Aesthetic rehabilitation and tissue
preservation in the anterior region
Jan-Frederik Güth1 and Hans-Jürgen Stecher2

While there are often several adequate prosthetic treatment options to choose from for
one single case, there are some cases where none of the proven solutions seems to be
perfectly suitable. The prosthodontist and his team have to balance the pros and cons
for each available option - they have to decide which treatment is best suited to fulfil
the needs of the specific patient. This was the case with a 16-year-old female patient
who presented at the Department of Prosthodontics of the Ludwig Maximilians University
of Munich, Germany, in 2015. An orthodontic treatment had just been completed and
a further prosthetic rehabilitation was required.

Background
At the age of 10, the patient had suffered an anterior tooth trauma with avulsion and
replantation of the maxillary central incisors (teeth 11 and 21, FDI notation). Despite all
efforts, it had not been possible to preserve tooth 21. The former dentist had replaced
it with a four-unit metal-ceramic adhesive bridge (Maryland bridge) (Figs. 1 & 2).
Unfortunately, the dismal prognosis for tooth 11 was confirmed in the course of
treatment: it had to be extracted during orthodontic therapy. In order to replace both
central incisors for the duration of this therapy, a provisional bridge with artificial gingiva
was manufactured and attached to the fixed orthodontic appliances (Fig. 3).

1

1

Dr Jan-Frederik Güth, PD

Jan_Frederik.Gueth@med.uni-muenchen.de
2

Hans-Jürgen Stecher, MDT
info@stecher-zahntechnik.de

3

4 INTERNATIONAL DENTISTRY - AUSTRALASIAN EDITION VOL. 12, NO. 2

2
Fig. 1: Situation prior to the orthodontic
treatment with an adhesive bridge used to
replace tooth 21.
Fig. 2: The adhesive bridge shows a
compromised fit after repeated removal and
placement.
Fig. 3: Snapshot during orthodontic treatment
with temporarily replaced central incisors.
(Image 1-3 courtesy of Prof. A. Wichelhaus)

Table of Contents for the Digital Edition of International Dentistry - Vol. 12, No. 2

Contents
International Dentistry - Vol. 12, No. 2 - Cover1
International Dentistry - Vol. 12, No. 2 - Cover2
International Dentistry - Vol. 12, No. 2 - Contents
International Dentistry - Vol. 12, No. 2 - 2
International Dentistry - Vol. 12, No. 2 - 3
International Dentistry - Vol. 12, No. 2 - 4
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International Dentistry - Vol. 12, No. 2 - Cover3
International Dentistry - Vol. 12, No. 2 - Cover4
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