Precision Attachment System Incorporated in A Pier Abutment Situation – A Case Report

Life Sciences- Dentistry

Abstract

In fixed prosthodontics, issues arise when dealing with certain situations, such as pier and tilted abutments, as rigid connectorsmay not be suitable. Pier abutments are terminal between natural teeth, supporting fixed or removable dental prostheses. FPDconnectors are components that connect the retainer and pontic. This study aimed to optimize retention and address long-spanedentulism adjacent to the pier abutment. The patient's medical history was not significant, but their dental history revealed extractionof a severely decayed left maxillary second premolar and first and second molars two years ago. A conventional eight-unit FPD withrigid connectors was placed, but it dislodged multiple times within two years. Rigid connectors in this situation would cause the pierabutment to act as a fulcrum due to tooth movement, arch position, and retainer retention. A non-rigid connector was incorporatedinto the fixed dental prosthesis to address this issue. The use of a non-rigid connector is preferred in constructing an FPD with a pierabutment was the aim of this study. The methodology followed was by placing the keyway on the distal side of the pier abutment aidsin seating the key and reducing the risk of dislodgment. Placing the keyway too close to the pier abutment can loosen the key, potentiallydamaging the canine retainer or causing bone loss around the canine abutment. Non-rigid connectors transfer less stress to abutmentsand allow for physiologic tooth movement. The design and passive fit of non-rigid connectors are crucial for the success of a long-spanFPD. The appropriate connector type is selected during prosthesis construction to prevent separation and failure of the FPD. A nonrigid connector enables movement within the FPD and distributes pressures away from the pier abutment. Therefore, selecting the rightarchitectural design, such as using a key and keyway, holds paramount importance in pier abutment scenarios and plays a crucial role inthe overall effectiveness of the Fixed Partial Denture (FPD) treatment. This case study intends to delve into applying a key and keywayas a flexible connector for restoring a patient dealing with a pier abutment condition.