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Amaris Gingiva Presentation Case

This middle aged patient wanted to eliminate her upper Cr/Co denture of 20 or more years. She needed a replacement at the very least as the existing denture had discoloured and become ill fitting and loose. She was also a smoker with no intention of giving up!

Furthermore she was unhappy with the appearance of the lower anterior teeth. Despite her good overall oral hygiene she was not a good candidate for gingival graft surgery. Like many patients , she was reluctant to undergo non-essential surgical procedures. Her gingiva is of a thin phenotype and she is a smoker. The cost of treatment was also a deterrant.

Even though significant recession has occurred in the past and the patient had a history of periodontal problems in her youth no periodontal pocketing was evident and her plaque scores were excellent. All relevant bridge support teeth tested positive with vitality testing. Nothing abnormal was evident radiographically.

A wax up was created using a conformative occlusal approach and I used this to create chairside bisacryl temporary bridges. The occlusion was stable without the denture in place and there is no history of unusual rates of tooth fracture. Most of the large amalgam fillings had been in place for 20 or more years. These factors made me confident to tackle this case in a conformative way. However I also took a preliminary PVS impression without retraction cord to have long term laboratory methacrylate bridges fabricated.

These were fitted 2 weeks later and remarginated chairside. I cemented them with eugenol containing temporary cement. The patient chose A1 shade and I viewed this as an opportunity to test:

• Colour
• Occlusal scheme
• Pulpal response to preparations

The permanent bridges were all of a fixed- fixed design and were fabricated with CAD-CAM substructures and bonded porcelain.

The lower teeth still required some form of treatment to improve appearance and protect the pulps. Conventional composite could be used but would give the teeth a very long appearance. Voco's new product, Amaris Gingiva seemed ideally suited to the problem. The correct shade was chosen using the enclosed gingival shade guide and the teeth were prepared for bonding in the usual way. The Amaris Gingiva product is a two stage system where an opaque base shade is first applied followed by a translucent pink composite layer. Finishing and polishing is the same as for any composite and the results are very convincing.

Both the patient and I were very pleased with the results achieved using Amaris Gingiva. I was able to provide an aesthetically pleasing, non-invasive and cost effective solution in a short time.
Dr. Colm O’Loghlen