Journal of Applied Dental and Medical Sciences

NLM ID: 101671413 ISSN:2454-2288

Volume 4 Issue1 Jan-March 2018
Review Article

Interrelationship Between Prosthodontics And Periodontics-A Review Article

Preetika bansal1, Pardeep Bansal 2, Tejinder 3

1
Associate Professor, Department of Periodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab
2
Professor & Head, Department of Prosthodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab
3
PG Student, Department of Prosthodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab

ARTICLE INFO ABSTRACT

Sound periodontium is of utmost importance for the success of restorative therapy and maintainence of
periodontal health for the long term success of prosthetic treatment. the collaborative disciple between
prosthodontics and periodontics are much needed for the good prognosis of the prosthodontic treatment.
For the facilitation of this collaboration, prosthodontists should appreciate the periodontic implications of
gingival displacement procedures and tooth preparation and should also have knowledgeable about the
types of gingival tissues, osseous topography, occlusal effects, and their implications for abutment choice.
Hence the prosthodontics and periodontics share an intimate and inseparable relationship in multiple
aspects, including treatment plan, procedures execution, outcome achievement and maintenance.

KEYWORDS: Prosthodontics,
Periodontics,Occlusal effects,
inflammation

INTRODUCTION
Sound periodontium is of utmost importance for the
success of restorative therapy and maintainence of achievement and maintenance. Periodontists provide a
periodontal health for the long term success of solid foundation for successful prosthetic outcomes by
prosthetic treatment. the collaborative disciple between controlling inflammation and preparing sites for proper
prosthodontics and periodontics are much needed for the prosthetic treatment. On the other hand, prosthodontists
good prognosis of the prosthodontic treatment. For the should make proper restorative margin, shapes and
facilitation of this collaboration, prosthodontists should contacts that benefit the harmony of periodontium and
appreciate the periodontic implications of gingival prosthesis. This article is aimed to addresses the
displacement procedures and tooth preparation and relationship between prosthodontics and periodontics.
should also have knowledgeable about the types of The impacts of healthy periodontium on longevity of
gingival tissues, osseous topography, occlusal effects, prostheses are discussed.
and their implications for abutment choice. Hence the
prosthodontics and periodontics share an intimate and
inseparable relationship in multiple aspects, including
treatment plan, procedures execution, outcome

*Corresponding author: Dr Pardeep Bansal, Professor & Head, Department of Prosthodontics, Dasmesh Institute of Research and
Dental Sciences, Faridkot, Punjab
 INTERRELATIONSHIP BETWEEN PROSTHODONTICS AND PERIODONTICS 4(1);2018 25

IMPLANT SUCCESS DEPENDANT UPON HEALTHY PERIODONTIUM AFFECTING

HEALTHY PERIODONTIUM PROSTHETIC THERAPY

Interdisciplinary dental rehabilitation should be Tooth prognosis should be addressed both on individual
contemplated as a long term solution for esthetic and tooth and the overall dentition before planning a
functional dental rehabilitation of patients. The treatment. All prosthetic and restorative therapies
therapeutic decisions must be based on the biological generally require a healthy periodontium as a
health of the periodontal and dental implant foundation prerequisite for successful outcome. Determination of
and must respect the functional occlusion and dental individual teeth prognosis allows a virtual approach on
alveolar anatomy to obtain longevity of the treatment. interdisciplinary conversation for treatment strategies as
Many deficiencies can be present in patients that include the important portion of dental practice. Heathy
loss of vertical dimension, dental caries, esthetics and periodontium is required for good prognosis of the
speech concerns, periodontal diseases and arch implant, so any peri-implant or active periodontal
discrepancies.for making an appropriate clinical disesase should be treated prior to the prosthodontic
treatment planning decisions,a thorough diagnosis and construction.signs of disesed periodontium include
evaluation of their prognosis is pertinent.it is must to pocket formation,presence pof bleeding on probing and
understand patient’s chief complaint and then the patient tissue changes of gingival. if the periodontal
must be made aware of various treatment options and inflammation is not controlled,it will lead to various
their effectiveness. adverse events of periodontal destruction. Function and
Nowdays dental implants have become an integral life span of prosthesis are compromised in case of
part in restorative dentistry. Todays impant dentistry is diseased periodontium.
not restricted to the basic needs but has evolved to In case of successful prosthetic treatments,periodontists
cosmetic or esthetic correction. Achieving a good help in preparing sites by soft and hard tissue
success rate in terms of stability is not the sole management. Regular periodontal maintainence is a key
requirement but esthetic success of the therapy is also a to reduce the incidence of tooth or implant loss following
major concern now. Maintaining the interdental papilla prosthetic therapy. In cases of lack of home care
and bone height along following implant placement has routines, professional assistance is necessary. The
been a challenge for the prosthodontist. The presence or Subgingival restorations are known to accumulate plaque
absence of interdental papilla associated with multiple from their cervical margins, the plaque is likely to
adjacent implants may be affected by the amount of proliferate apically and cause periodontal destruction and
alveolar bone loss prior to implant placement ,distance loss of the tooth. Regular compliance of periodontal
between adjacent implants, position of implants in maintenance is the key to prevent the recurrence of
relation to adjacent teeth as well as the subgingival periodontal diseases and to maintain the integrity of
contours of the implant supported restoration. treatment outcomes.

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RELATION BETWEEN FIXED The design of partial denture also plays a role in
PROSTHODONTICS AND PERIODONTICS progression of periodontal disease.in cases where lingual
In case of fixed prosthodontics,the chief complaint is plates or lingual bas were used as major connectors,tooth
inability to eat satisfactorily due to missing teeth.patients mobility was significantly reduced due to the indirect
requirement is replacement of missing teeth with fixed retention provided by them
prosthesis.in such cases it is critical to assess the
abutment via periodontal perspective for long as well as Biologic Width
short term treatment planning.many periodontal factors
needs to be examined before finalizing the treatment plan The biologic width is defined as the dimension of the
like tooth mobility,furcation involvement,severity of soft tissue, which is attached to the portion of the tooth
bone loss,bleeding or exudation from gingival pockets.if coronal to the crest of the alveolar bone. This term was
any of these factors is compromised ,proper periodontal based on the work of Gargiulo et al. (1961), who
healthof abutment teeth should be achieved before described the dimensions and relationship of the
giving a fixed prosthesis. dentogingival junction in humans14. biologic width is a
Maintainence of periodontal health and prevention of cuff-like barrier that acts as a protective physiological
gingival breakdown should be kept in ming while seal around natural teeth. The violation of Biologic width
designing and fabricating a fixed prosthesis. The given has been widely discussed as a contributing factor which
fixed prosthesis should be self cleansing and at the same jeopardizes periodontal health.
time esthetic and functional. There are greater chances of The signs of Biologic width violation consist of pain,
pocket depth and increased loss of clinical attachment gingival inflammation, localized gingival hyperplasia,
levels in case of open contacts between the crowns and pocket formation, and loss of periodontal apparatus.
the adjacent teeth. Food entrapment and plaque Therefore, further corrective procedures should be
accumulation can be prevented by supragingival considered prior to restorative treatments if any qualms
margins. about Biologic Width violation, including orthodontic
extrusion and surgical crown lengthening procedures.
PERIODONTAL THERAPY AND REMOVABLE
The periodontium are classified into three dimensions:
PROSTHODONTICS
superficial physiologic, crevicular physiologic, and
Fixed prosthodontics is not always feasible in patients,
subcrevicular physiologic by maynard & Wilson in 1979.
even in case of sound periodontium due to financial or
The superficial physiologic dimension represents the free
medical conditions. Removable prosthesis are retained
and attached gingiva surrounding the tooth, while the
by means of clasps and retentive arms on the abutment
crevicular physiologic dimension represents the gingival
teeth adjoining edentulous spaces. Faulty design of
crevice – extending from the free gingival margin to the
prosthesis leads to leads to food entrapment ,which in
junctional epithelium. The subcrevicular physiologic
turn increases plaque accumulation and thus there are
space is analogous to the biologic width.
higher chances of periodontitis. Higher prevalence of
gingivitis, plaque, and gingival recession on abutment
teeth as compared to non abutment teeth.

Journal Of Applied Dental and Medical Sciences 4(1);2018

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marginal bone resorption even under the circumstance of

healthy peri-implant tissue.fracture of prosthetic
component and loosening of attach,ent or abutment can
also occur along with implant overloading ,many other
complications contribute to biomechanical implant
complications like bony quality, implant designs,
prosthetic designs and parafunction. Occlusion should be
checked prior to dealing with the mechanical
complications. Elimination or control of contributing
factors should be done before repairing or replacing
lossened of fractured components. Non-surgical or
surgical intervention may be needed in many cases,
patient is advised to wear occlusal splint to prevent
biomechanical complication.

Conclusion
Trauma from occlusion
With a harmonious stomatognathic system, the
The tooth and its supporting structures bear the brunt of
relationship between prosthodontics and periodontics is
occlusal forces on the crown,as a functional unit. As a
intimate and inseparable.interdiscilinary care for dental
result of occlusal forces the attachment apparatus may
rehabilitation can be provided with prosthodontics and
experience tissue changes, including injury, repair and
periodontics working together.the treatment should be
adaptive remodeling of the periodontium.
guided by accurate diagnosis,proper evaluation and
Trauma From Occlusion including occlusal disharmony,
coordinated planning.Regaining stable periodontal
parafunction (i.e. clenching and bruxism), and occlusal
conditions rely on establishment of proper contact types,
schemes. Although the role of Trauma From Occlusion
occlusal scheme and quality prosthesis. Both specialty
plays in periodontal/ peri-implant diseases remains
share a common goal: to create pleasing esthetic
controversial, clinicians should perform prosthetic
treatments with caution to avoid failure following
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