MGV’S KBH DENTAL COLLEGE & HOSPITAL,

PANCHAVATI, NASHIK-3

DEPARTMENT OF PROSTHODONTICS

CLINICAL
ALBUM CASE RECORD

DR. PRANAV PRAKASH PUND

POST GRADUATE STUDENT
YEAR 2021-2024.

3
 INDEX

SR PAGE
NO CASE NO
1. MANAGEMENT OF COMPLETELY EDENTULOUS PATIENT 1-18
WITH RESORBED RIDGE IN MANDIBULAR ARCH USING
NEUTRAL ZONE TECHNIQUE
2. MANAGEMENT OF ANTERIOR DEFECT USING GINGIVAL 19-25
PORCELAIN
3. KENNEDYS CLASS 2 MODIFICATION 3 WITH CAST PARTIAL 26-38
DENTURE IN MAXILLARY ARCH AND OVERDENTURE WITH
MANDIBULAR ARCH
4. IMMEDIATE EXTRACTION AND IMMEDIATE IMPLANT 39-46
PLACEMENT IN 45 YEAR OLD MALE PATIENT

5. ANTERIOR GUIDANCE 47-57

6. REHABILITATION OF COMPLETELY EDENTULOUS 58-77

MAXILLARY ARCH WITH GUIDED FLAPLESS ALL ON FOUR
IMPLANT PLACEMENT
7. MANAGEMENT OF PARTIALLY EDENTULOUS PATIENT 78-87
WITH IMPLANTS,VEENERS AND FULL COVERAGE
8. REHABILITATION OF A PATIENT WITH HEMI 88-95
MANDIBULECTOMY WITH PALATAL RAMP PROSTHESIS
9. DIGITAL FULL MOUTH REHABILITATION 96-110

10. COMPLETE DENTURE WITH BALANCED OCCLUSION 111-120

11. MANAGEMENT OF PIER ABUTMENT USING TENON-MORTISE 121-123
NON RIGID CONNECTER
12. MANAGING PATIENT WITH CLICKING SOUND IN TMJ 124-132
WITH STABILIZING SPLINT

13. SINGLE VEENER. 133-141

4
14. MANAGEMENT OF PARTIALLY EDENTULOUS PATIENT WITH 142-153
SEMI GUIDED IMPLANTS

15. MANAGEENT OF HEMIMANDIBULECTOMY PATIENT WITH 154-163

GUIDING FLANGE

5
 CASE 1

RESORBED MANDIBULAR RIDGE USING

NETRAL ZONE TECHNIQUE

➢ Patient Name: Mr. Shahida sayyed

➢ Age/Sex: 58 Years / Female.

➢ Chief Complaint: Patient complains of missing teeth in maxillary and

mandibular arch.

➢ On Examination: Completely edentulous maxillary and mandibular arch.

Resorbed ridge is present in Mandibular arch.

Treatment Plan: Complete denture with maxillary and mandibular arch.

6
 Intra oral photographs

Maxillary arch Mandibular arch

Primary impression

7
Secondary impression

Orientation jaw relation

8
Facebow transfer on semi-adjustable articulator

9
Preparation of wire loops

10
 Modified mandibular denture base

Adjusted green stick and impression compound on modified

Mandibular ridge for maintaining vertical dimension
11
Adjusted green stick and impression compound on modified
Mandibular ridge for maintaining vertical dimension

Patient performing series of movements

12
 Obtained neutral zone

Putty index for making of occlusal rims according to recorded 13

Neutral zone
Occlusal rims according to neutral zone

14
Teeth arrangement according to recorded neutral zone 15
 Teeth arrangement on semi adjustable articulator

Try-in maxillary Try-in mandibular

Occlusal view Occlusal view

16
Right lateral view Left lateral view

Frontal view

17
Pre operative Post operative

frontal view frontal view

18
 CASE 2
MANAGEMENT OF ANTERIOR DEFECT
USING GINGIVAL PORCELAIN

➢ Patient Name: Mr.Anita Bajpayee

➢ Age/Sex:43 Years / Female.

➢ Chief Complaint: Patient complains of missing of anterior teeth in

mandibular arch.

➢ On Examination: Patient had a severe bone loss in anterior part of mandible.

Treatment Plan: Fixed partial denture with gingival porcelain.

19
 Pre operative Frontal view

Pre operative right lateral view Preoperative left lateral view

20
 Mandibular arch
Maxillary arch

Pre operative mandible view

Pre operative Maxillary view

Diagnostic Diagnostic
Maxillary impression Mandibular impression

21
Articulation on semi adjustable
articulators

22
Diagnostic wax mock upon
semi adjustable articulator

23
Tooth preparation Final impression with
heavy body (addition
silicon) and light body

Post operative Frontal

view

24
Post operative right lateral view Post operative left lateral
view

Extraoral Preoperative Frontal view Extraoral Post operative Frontal

view

25
 CASE 3

KENNEDYS CLASS 2 MODIFICATION 3 WITH

CAST PARTIAL DENTURE IN MAXILLARY
ARCH AND OVERDENTURE WITH
MANDIBULAR ARCH

➢ Patient Name: Mrs radhabai gaikwad

➢ Age/Sex:63Years / Female.

➢ Chief Complaint: Patient complains of missing teeth in maxillary and

mandibular arch and inability to eat.

➢ On Examination: Patient had fault fixed prosthesis with maxillary arch and

root pieces in mandibular arch.

Treatment Plan: Cast partial denture with maxillary arch and overdenture with
mandibular arch.

26
 Extra oral photographs

Frontal view

Right lateral view Left lateral view

27
 INTRAORAL PHOTOGRAPHS

Maxillary arch Mandibular arch

Frontal view

28
PREPARATION OF CANAL AND DIRECT
IMPRESSION TECHNIQUE

Canal preparation with 33 Canal preparation with 33

Intraoral photographs with pin

jets for metal copings

29
Metal coping with 33 and 43

Diagnostic mandibular
cast

30
 Border moulding Zinc oxide eugenol
With low fusing compound Final impression

Master cast

31
Maxillary arch Diagnostic cast

Designing of cast partial

denture

32
Surveying

33
Final impression for metal
framework

Metal framework

34
 Facebow records

Facebow transfer on semi adjustable articulator

35
 Teeth arrangement on semi adjustable articulator

Frontal view

Right lateral view Left lateral view

36
 Intraoral photographs of Tryin

Maxillary arch Mandibular arch

Frontal view

Right lateral view Left lateral view

37
 Maxillary arch Frontal view

Right lateral view Left lateral view

38
 CASE 4

IMMEDIATE EXTRACTION AND

IMMEDIATE IMPLANT
PLACEMENT IN 45 YEAR OLD
MALE PATIENT

➢ Patient Name: Mr. Chandrashekar pagare

➢ Age/Sex:45 Years / Male.

➢ Chief Complaint: Patient complains of inability to eat due to root pieces

➢ On Examination: patient had root pieces in upper left back region of jaw

Treatment Plan: immediate extraction and immediate implant placement with 25

26 .

39
 Pre operative CBCT

Extracted root pieces with 25 26

40
 Osseodensification with 25 26

Implant size 4.3*8mm Implant size 4.3*8mm

41
 Implant placement with 25 26

Simple interrupted sutures Intraoral radio graph with 25 26

placed

42
 Determination and evaluation for second-stage surgery

Placement of healing Gingival collar formation

abutment

43
 Open tray implant Intra-oral radiograph with
impression with 25 26 impression coping

Intra oral photograph Intraoral radiogarph with jig

with jig trail with 25 26 trail with 25 26

44
Implant prosthesis placed Intraoral radiograph with
with 25 26 25 26

In centric relation In protrusive

45
Left lateral view Right lateral view

46
 CASE 5
Anterior guidance

➢ Patient Name: Mr. leelabai dhadiwal

➢ Age/Sex:63Years / Female.

➢ Chief Complaint: Patient complains of inability to chew food and lacking

confidence in smiling and talking

➢ On Examination: Patient had attrided and maxillary anteriors and extruded

mandibular anteriors

➢ Treatment Plan: Fixed partial dentures with maxillary and mandibular

anteriors followed with crown lengthening procedures.

47
Frontal view Lateral view

Orthopantomogram

48
 Frontal view

Right lateral view Left lateral view

49
Maxillary arch

Mandibular arch

50
Diagnostic maxillary Diagnostic Mandibular arch
impression

Facebow records Lateral view of face bow records

51
 Determining vertical dimension

Diagnostic mock up frontal view Diagnostic mock up lateral view

52
Endodontic treatment for maxillary and mandibular anteriors

Guidelines for crown lengthening procedures

53
Crown lengthening procedures for mandible

54
Tooth preparation with gingival Temporization
retraction cord

Guide line for maxillary arch crown lengthening procedures

55
Fiber post preparation

Tooth preparation

Temporization

56
 Post op extraoral photographs

Before After

57
 CASE 6

Rehabilitation of completely edentulous maxillary

arch with guided flapless all on four implant
placement

➢ Patient Name: Mrs Sheela chandratre

➢ Age/Sex: 57 Years / Female.
➢ Chief Complaint: Patient complains of missing teeth in maxillary arch and is
unable to chew food
➢ On Examination: Missing with maxillary arch and 47,36,37
➢ Treatment Plan: Fixed implant supported Prosthesis.

58
 Pre operative CBCT

Intra oral photographs

Maxillary arch Mandibular arch

59
 Primary impressions

Maxillary arch Mandibular arch

Secondary impressions

Border molding with low Final impression using zinc

fusing impression compound oxide eugenol Impression
paste

60
 Face bow transfers

Frontal view Right lateral view

Facebow transfer on semi adjustable articulators

61
 Denture insertion

Frontal view Occlusal view

Extra oral photograhs

Frontal view Right lateral view

62
Treatment planning for implant for positioning and angulation

63
Designing of surgical stent according to implant placement

64
 Fabricated surgical stent with sleeves

Occlusal surface Intaglio surface

Armamentarium

65
Placement of anchor pins

Punching tissue holes

66
 Pilot drill

Implant placement

67
Implant placement with cover screw

Placement of multiunit abutment

68
 Placement of titanium cylinders

Occlusal view Frontal view

Placement of denture on temporary cylinders for denture conversion

Application of pattern resin on temporary

clyinders

69
Polishing and finishing for denture conversion

Intra oral photographs

70
 Extra oral photographs

Digital impression using multiunit abutment

71
Cad cam printed models

Intra oral jig trail

72
OPG wearing a jig trail

Designing of resin trail

73
Intra oral photographs with resin trail

Designing of metal trail

74
Designing of bisque trail

Definitive prosthesis

75
 Intra oral photograhs

Occlusal view Frontal view

Right lateral view Left lateral view

76
Extra oral photographs

77
 CASE 7

Management of partially edentulous patient

with implants,veeners and full coverage
crowns.

➢ Patient Name: Ms smita paul

➢ Age/Sex: 43 Years / Female.
➢ Chief Complaint: Patient complains of missing teeth in maxillary and
mandibular arch and is unable to chew food
➢ On Examination: Missing with 14,15,16,26,36,37,46,47.
➢ Dental history: Tooth colored restorations and endodontic treatment with 17
27 34.
➢ Medical history: No relevant history.
➢ Treatment Plan: Removable partial denture, fixed partial denture, implant
supported denture.

78
 Extra oral photographs

Frontal view

Intra oral photographs

Maxillary arch Mandibular arch

79
 Face bow records

Frontal view Right lateral view

Evaluating vertical dimension

80
 Programming of an articulator

Frontal view Left lateral view

Wax up

Frontal view Left lateral view

81
 Putty index

Intra oral photographs after implant placement

Maxillary arch Mandibular arch

82
Frontal view Right lateral view

Digital impressions

83
Veener preparation

Digital impressions

84
Veener designing

Before cementation

Frontal view

85
 Digital implant impression

Cementation f definitive implant prosthesis

Maxillary arch Mandibular arch

86
 In maximum intercuspation

Right lateral view Frontal view Left lateral view

Post operative extraoral photographs

Frontal view Smiling view

87
 CASE 8

REHABILITATION OF A PATIENT WITH

HEMI MANDIBULECTOMY WITH PALATAL
RAMP PROSTHESIS

➢ Name: Mr Aslam Pathan.

➢ Age sex: 55 years old male.
➢ Chief complaint: patient complain of inability to eat since 20 days.
➢ Dental history: resection of mandible from 33 to 38, 20 days ago.
➢ Medical history: History of hemi mandibulectomy of left side following
squamous cell carcinoma of buccal mucosa 20 days ago.
➢ Habit history: history of Tabacco chewing since 15 years 10 times a day.
➢ Diagnosis: Class III Cantor and Curtis hemimandibulectomy classification.
➢ Treatment options:
➢ Reconstruction of mandible, followed by implant supported fixed prosthesis
in mandibular arch and removable prosthesis with twin occlusion for
maxillary arch
➢ Palatal ramp prosthesis for maxillary arch to aid in mastication
➢ Guide flange prosthesis.
➢ Patient opted for option 2

88
 Preoperative extraoral photographs

Preoperative occlusal photographs

Maxillary arch Mandibular arch

89
 Preoperative intraoral view

Frontal view Mouth opening 21mm

Preoperative OPG

90
 Diagnostic impressions

Primary impression Primary cast

Mandibular cast
Mandibular impression

91
 Fabrication of record base

Denture base on primary cast Cold cure acrylic denture base

Orientation jaw relation

92
 Recording of interocclusal record

Interocclusal record insitu

Interocclusal record ex situ

Interocclusal record on cast Teeth arrangement

93
 Tryin

Occlusal view Maximal intercuspation

Palatal ramp prosthesis

Occlusal surface Intaglio surface

94
 Prosthesis insertion

Occlusal view Maximum intercuspation

95
 CASE 9
DIGITAL FULL MOUTH REHABILITATION

➢ Name: Mr Manish paul .

➢ Age sex: 47 years old male.
➢ Chief complaint: patient complain of discoloration of teeth
➢ Dental history: Generalised attrition .
➢ Medical history: No relevant medical history.
➢ Habit history: history of smoking cigarettes from 20 years 5-6 times a days

96
 Preoperative extra oral photographs

Frontal view Front smiling view

Right lateral view Left lateral view

97
 Preoperative intra oral photographs

Maxillary arch Mandibular arch

Frontal view

Right lateral view Left lateral view

98
 Diagnostic impressions

Maxillary arch Mandibular arch

2D DSD smile design frame

99
 2D simulation

Preoperative frontal view 2D simulation with software

Preoperative IOS

Frontal view Right lateral view

100
 3D motivational design

Frontal view Right lateral view

3D Printed motivational design

Frontal view
Occlusal surface

101
 3D motivational test drive

Frontal view Left lateral view

Kois deprogrammer

Occlusal view Intaglio surface

102
 Kois deprogrammer exsitu

Kois deprogrammer in situ

Occlusal view

Right lateral view Left lateral view

103
 3D Non prep design functional ideal virtual

Preoperative model Digital design n software

104
 3D functional Non prep design functional ideal test drive

Frontal view in MIP

Left lateral in MIP

3D functional ideal virtual prep design test drive

Frontal view Occlusal view

105
Mandibular arch Occlusal view

106
 Provisional for anteriors

Frontal view

Right lateral view

Left lateral view

Maxillary occlusal view Mandibular occlusal view

107
 Tooth preparations for posteriors

Maxillary arch
Mandibular arch

Temporizations with posteriors

Maxillary arch Mandibular arch

108
 Intra oral photographs in MIP

Right lateral view Frontal view Left lateral view

In protrusion

Frontal view

Right lateral view

Left lateral view

109
 Extra oral photographs

12 o clock view

Right lateral view Left lateral view

110
 CASE 10

COMPLETE DENTURE WITH

BALANCED OCCLUSION

➢ Patient Name: Mrs Ashok Gaikwad

➢ Age/Sex:65Years / Female.

➢ Chief Complaint: Patient complains of missing teeth in maxillary and

mandibular arch and inability to eat.

➢ On Examination: Patient was completely edentulous with maxillary and

mandibular arch.

Treatment Plan: complete denture with balanced occlusion

111
 Extra oral photographs

Frontal view Frontal smiling view

Intra oral photographs

Maxillary arch Mandibular arch

112
 Primary impressions

Maxillary arch Mandibular arch

Secondary impression

Mandibular arch
Maxillary arch

113
 Orientation jaw relation

Right lateral view Frontal view Left lateral view

Face bow transfer on semi adjustable articulator

Right lateral view Left lateral view

114
Mounting on semi adjustable articulator

Gothic arch tracing with intraoral records

115
 Programming of an articulator

Frontal view Left lateral view

Right lateral view Left lateral view

116
 Teeth arrangement on semi adjustable articulator (balanced)

Frontal view Left lateral view

117
 Tryin

Right lateral view Frontal view Left lateral view

Denture insertion

Maxillary occlusal view Mandibular occlusal view

118
 Frontal view

Right lateral view Left lateral view

119
 In protrusion

Frontal view

Lateral excursion Lateral excursion

120
 CASE 11

MANAGEMENT OF PIER ABUTMENT USING

TENON-MORTISE NON-RIGID CONNECTER

➢ Patients name : Prakash Pangawane.

➢ Age : 58 years old/Male.
➢ Chief complaint : inability to eat due to missing teeth.
➢ on examination : missing teeth 16, 17 and 27.
41,44,46 and 32,33.
➢ History of dental extractions 3 months ago also gave history of root canal
treatment in lower left region of jaw.
➢ Medical history : patient was exposed to covid-19 2 years back.
➢ Treatment plan: PFM fixed partial denture using tenon mortise non rigid
connector with 43,44,45,46,47.

121
 Intra oral photographs

Maxillary arch Mandibular arch

OPG

122
 Intra oral frontal view

Diagnostic cast

Maxillary arch Mandibular arch

123
 CASE 12
MANAGING PATIENT WITH CLICKING
SOUND IN TMJ WITH STABILIZING SPLINT

➢ Name: Ms Riya Parrekh

➢ Age sex: 19years old Female.
➢ Chief complaint: patient complain of inability to open and close mouth since
1 month.
➢ Dental history: No relevant history.

➢ Medical history: No relevant history.

124
 Extra oral photographs

Frontal view Frontal smiling view

Intra oral occlusal view

Maxillary view Mandibular view 125

 Intra oral frontal view

Right lateral view Left lateral view

In protrusion

Frontal view

126
Right lateral view Left lateral view

Diagnostic impressions

Maxillary arch Mandibular arch

127
 Orientation jaw relation

Frontal view Right lateral view

Face bow records transfer

Frontal view Left lateral view

128
Frontal view Right lateral view

Digital designing

129
130
 Fabricated milled splint

Intaglio surface Occlusal surface

Splint in situ

131
Right lateral view Left lateral view

132
 CASE 13
MANAGING ELLIE’S CLASS 2 FRACTURE WITH
VENEER

➢ Patient Name: Shreya wagh

➢ Age/Sex: 19 Years / Female.
➢ Chief Complaint: Patient complains of fractured tooth in upper front region
of jaw.
➢ On Examination: fractured with 21
➢ Dental history: NRH
➢ Medical history: No relevant history.
➢ Treatment Plan: Veener restoration with 21.

133
 Extra oral photographs

Frontal smiling view Frontal view

Right lateral view Left lateral view

134
 Intra oral photographs

Maxillary view Mandibular arch

Frontal view

135
 Right lateral view Left lateral view

Orientation jaw relation

Frontal view Right lateral view

136
Frontal view Left lateral view

Tooth preparation

137
138
 Cementation protocol

Application of 37% of phosphoric acid Application of universal bond

Light curing

Application of 9.6% of hydrofluoric acid Application of silane agent

139
Intra oral photographs

Frontal view

Right lateral view

Frontal view

140
12o clock view

Extra oral view

141
 CASE 14

MANAGEMENT OF PARTIALLY
EDENTULOUS PATIENT WITH SEMI
GUIDED IMPLANTS

➢ Patient Name: saddam shah

➢ Age/Sex: 19 Years / male
➢ Chief Complaint: Patient complains of missing teeth upeer ront region of
jaw.
➢ On Examination: missing with 14 13 12 11 21 22 23 24
➢ Dental history: NRH
➢ Medical history: No relevant history.
➢ Treatment Plan: Pt was advised with removal partial denture was advised
with fixed partial denture and implant supported prosthesis
➢ Pt opted with implant supported prosthesis.

142
 Diagnostic cast

Maxillary arch Mandibular arch

Final impression

Pick up impression for maxillary Maxillary arch

arch

143
 Orientation jaw relation

Right lateral view Frontal view Left lateral view

Facebow transfer

Frontal view

144
 Left lateral view

Teeth arrangement

Frontal view Right lateral view

145
 Tryin

Left lateral view Frontal view Left lateral view

Maxillary occlusal view

Extra oral photographs with trying

146
 Denture insertion

Right lateral view Frontal view Left lateral view

Extra oral photographs

147
CBCT wearing denture with radiographic markers

148
Armamentarium for implant placement

Pilot drill with implant placement

149
Intraoral radiograph with 15 13 24

Jig trail

150
 Metal trail

Intra oral photographs

Maxillary occlusal view

151
 Frontal view

Right lateral view Left lateral view

152
 Extra oral photographs

Frontal view Frontal smiling view

Right lateral view

153
 CASE 15
MANAGEMENT OF HEMI MANDIBULECTOMY
PATIENT WITH GUIDING FLANGE

➢ Name: Mrs Hirabai Pulwale

➢ Age: 55 years
➢ Gender: Female
➢ Chief Complaint: Patient complains of difficulty in eating since
past 1 year.
➢ Dental History: Resection of mandible from region of 33 to 38, 1
year ago.
➢ Medical History: History of hemi mandibulectomy of left side
following squamous cell carcinoma of buccal mucosa 1 year ago.
➢ Habit History: History of tobacco chewing since 20 years 10 times
a day.
➢ Diagnosis: Class III Cantor and Curtis hemimandibulectomy
classification
➢ Treatment option: Reconstruction of mandible, followed by
implant supported fixed prosthesis in mandibular arch and
removable prosthesis with twin occlusion for maxillary arch
➢ Palatal ramp prosthesis for maxillary arch to aid in mastication
➢ Guide flange prosthesis.
➢ Patient opted for option 3

154
 Preoperative extraoral photographs

Right lateral view Frontal view Left lateral view

Preoperative intraoral photographs

Maxillary arch Mandibular arch

155
 Frontal view

Mouth opening of 21mm

156
 Preoperative OPG

Diagnostic impression

Primary impression Primary cast

157
 Mandibular arch Primary cast
primary impression

Orientation jaw relation

158
 Articulation

Frontal view

Right lateral view left lateral view

159
 Clasp design

Wax design of guide flange prosthesis

160
Flasking and dewaxing

161
 Guide flange prosthesis

Lateral occlusal view Intaglio surface

Medial occlusal view Medial surface

162
 Guide flange prosthesis insertion

Right lateral view Right lateral

Occlusal view Frontal view

163