Original Article
Published on
01/04/97
ESSIXÔ* Appliances
The Fabrication of a Temporary Bridge
to Replace Missing Anterior Teeth
Elliott M. Moskowitz (1),
D.D.S.,M.Sd,
John J. Sheridan (2), D.D.S.,M.S.D.,
Kruno Tovilo (3), D.M.D.
(1)Clinical Associate Professor, New York University College of Dentistry Department of Orthodontics
(2) Professor, Louisiana State University School of Dentistry Department of Orthodontics
(3) Private Practice of Orthodontics Mississauga, Ontario, Canada
*ESSIX-Raintree Corp.,P.O. Box 9540, Matairie, LA 70055
Editor Note:
Dr. J. Jack Sheridan has a financial interest in the ESSIX Raintree company. All profits
from the ESSIX technology are donated to the Department of Orthodontics at Louisiana State University School of Dentistry , New Orleans, USA for an endowed chair.
The advantages of utilizing ESSIXÔ* thermoformed appliances as retention devices and minor tooth movement
appliances in clinical practice have been described.(1)(2)(3)(4)(5)
A very useful application of the ESSIXÔ* thermoformed appliances is the
fabrication of temporary bridges to replace missing anterior teeth. Orthodontists,
pedodontists, and general dentists/implantologists are frequently challenged with
providing an esthetic and functional provisional prosthesis for patients who will later
receive a single tooth implant supported restoration or other type of replacement for
missing anterior teeth. The purpose of this article is to describe the fabrication of an
esthetic and functional provisional prosthesis using ESSIXÔ*
thermoforming technology.
The patient, C.R., has congenitally missing maxillary left
and right lateral incisors (Figures 1 and 2) and has just 
completed
orthodontic treatment. A conventional Hawley type of retainer (Figure 3) was placed
to maintain the space for implant supported restorations to replace the maxillary lateral
incisors. Some of the potential problems with such "conventional" retainers
include occlusal interferences from clasps, esthetic limitations, due to the blatantly
obvious labial bow, speech problems, resulting from the bulkiness of the appliance, and
palatal soft tissue irritations as a result of "settling" of the acrylic
framework (Figures 4 and 5).
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Clearly, an alternative appliance would serve the
patient better while she is waiting for the ultimate prosthesis (crowns on implants).
The Technique
The fabrication technique for an Essix appliance is presented below.
1. Employing a universal, anterior-perforated plastic tray, obtain an impression using a combination of heavy and light vinyl polysiloxane impression material.
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Trim away the impression material distal to the canine-since only the canine-to-canine teeth will be included in the appliance--and box with baseplate wax (Figures 6 and 7). |
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2. Pour the impression with a high quality die stone. |
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Minimal trimming on the base of the cast is required if the previous instructions have been followed (Figures 8 and 9). |
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3. After placing a separating medium in the edentulous areas, fit an apropriate pontic to the edentulous alveolar ridge. Cut a mesiodistal trench about 4mm wide and 3mm deep into the lingual surface of the pontic (Figure 10). This will create a mechanical lock for the pontic during the thermoform process.
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4. After checking the incisal efficiency of the pontic (Figure 11), secure it in place with a quick-cure or light-cured acrylic. Don’t use wax. It will melt during the thermoforming process.
5. With the pontic secured on the cast, thermoform the Essix plastic sheet (.030") over the cast (Figure 12). This can be done on vacuum or pressure thermoforming machines.
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6. Trim the appliance with curved Mayo scissors to the configuration shown in Figure 13. Cutting the appliance in the manner shown will allow the patient to easily remove it with a fingernail purchase along the distogingival edge of the appliance. |
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The completed Essix constructed temporary bridge is shown (Figures 14 and 15). Patient acceptance of this extremely esthetic and durable temporary bridge has always been enthusiastic. They have proven to be reliable, esthetic, and functional temporary appliances to replace missing anterior teeth. Additionally, Essix appliances have been used extensively in private practices and tested by orthodontic and oral implantology departments of major universities. |
References
