Insight 21 — Temporarily Providing Posterior Support in Extensive Reconstructions

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Clinical explanation

Without a correct posterior stop, the restorations and crowns of the anterior teeth are doomed to fail, and before undertaking the reconstruction of the anterior teeth one must always make sure that an adequate posterior stop exists; otherwise, contact of the anterior teeth without the support of the posterior teeth causes oblique forces to be applied to the anterior teeth, which increases the likelihood of damage to and loss of the treated anterior teeth.

In the patient whose photo is shown, we were performing an extensive reconstruction of both jaws. At the previous session, all the post and cores were cemented and the teeth were scanned so that the temporary crowns could be delivered to the patient at this session.

With the cementation of the temporary crowns, both function and esthetics are restored to the patient, and the support of the posterior teeth also relieves the pressure from the anterior teeth.

But the point was that in the existing situation at the previous session — where all the teeth had post and cores and there was no posterior stop even in a temporary form — there was heavy contact on the anterior teeth and post and cores, and the likelihood of these teeth failing during the interval while the temporary crowns were being prepared was high.

An innovative solution

To prevent this problem, a small amount of composite was temporarily bonded onto selected posterior teeth at an appropriate VD, so that during the interval while the temporary crowns were being prepared, no pressure would be applied to the anterior teeth and they would be protected.

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To bond the composite to the metal core, the metal-bonding method previously explained in the podcasts was used.

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