Using a clear aligner-like tray to temporarily hide a gap following tooth extraction

In this case, the patient is a 58- year old woman presenting with a gap in upper right teeth following extractions of #5 and #6 with another dentist 8 months prior.  The patient is also missing #2 and #3, meaning she is edentulous #2-#6.  Her other dentist made her a partial denture to fill in the gap, but the patient cannot tolerate wearing the device due to a heavy gag reflex.

In order to give the patient a temporary solution to fill the gaps in her teeth, a removable splint aligner was crafted with a tooth colored temporary filling to fill in the large gap on the upper right.  However, the patient could not tolerate wearing her partial denture, so we were unable to take an impression of the upper arch with the partial denture inserted.  To circumvent this issue, an impression was taken both of the patient’s upper arch (without the partial denture) and of the patient’s partial denture.  A second model of the upper arch was also poured, in order to fit and shape the temporary teeth to the gum line.  After pouring the molds, the model of the denture was cut and trimmed so that only the tooth-like structures used to fill in the gap on the upper right remained.  This was then trimmed to fit the contour of the gum line in the gap and grafted onto the model of the patient’s upper arch using some additional wet stone.

After the grafted model was set, a 0.020 splint retainer was made.  Forming the retainer after the denture model was grafted onto the upper arch model allowed us to form a negative of the tooth-like structures from #2-#6.  At this point, the partial denture was used to obtain a shade for the temporary teeth (A2).  After the retainer was trimmed to fit the model, blue wax was used to block off #1 and #7 on the aligner so that temporary filling material could be placed in the gap between them.  Luxatemp was used to fill in the tooth-like structures in the upper right gap. After the temporary filling had hardened, the aligner with the temp was fit back onto the second model of the upper arch.  Articulating paper and a laboratory handpiece was used to contour the temp to the gumline in the gap.  The finished aligner properly fits onto the upper arch and contains a four-tooth, tooth colored temp to fill in the large gap on the upper right.

— written by Patrick Rowan

Patrick has been a full-time pre-dental student at The Center for Special Dentistry since June 2018. He worked closely with Dr. Jeffrey Dorfman on this, and many other, interesting cases. Pat’s overall grade for the first four months has been A+.

Categorised in: Dental Student Experiences

This post was written by Dr. Jeffrey Dorfman