Aging and medically compromised periodontal prosthodontic patients--salvaging abutment teeth undermined by root...

Aging and medically compromised patients are retaining their teeth longer. With the prolonged use of medications that produce xerostomia, these patients become more caries susceptible. Root surface caries, which undermines abutment crowns, results in loss of abutments because it is difficult to detect incipient lesions and make appropriate repairs before a significant amount of coronal dentin is lost. With the absence of a significant amount of coronal dentin, routine preparation and impression techniques can result in failure and frustration. For many such patients crown lengthening is the treatment of choice. It provides the restorative dentist convenient access and visibility. However, surgery may be contraindicated because of unfavorable anatomy. It may also be refused by the patient, often upon the advice of a physician. This article provides predictable alternatives for routine preparation and impression techniques. Documentation substantiates the long-term efficacy of these alternatives.