Management of extruded maxillary molars to accomodate a mandibular

Abstract

Prosthodontic treatment for posterior mandibular edentulous area with the extruded opposing maxillary segment has been a challenge to clinicians. It is necessary to regain original space and to correct the occlusal plane for the ideal prosthodontic treatment. Several approaches have been introduced to solve this problem based on the severity of supereruption: (1) no treatment; (2) restoration of the mandibular occlusion in an abnormal occlusal plane with a shortened prosthesis; (3) reduction of coronal parts of the teeth to provide restorative space and to correct the occlusal plane, it may require endodontic treatment, periodontal surgery, and a fixed prosthesis1; (4) surgical impaction by the subapical osteotomy2 and 3; or (5) orthodontic intrusion of the extruded teeth.4 and 5 Each method has advantages and disadvantages. Consequently, the dentist will select the treatment option according to clinical situation.

This clinical report describes the effect of combining treatments for a patient with an extruded maxillary segment. The posterior mandibular edentulous area was restored with a fixed implant-supported prosthesis after the correction of the occlusal plane, vertical space, and contact points by using a fixed orthodontic appliance (molar intrusion arch).