A patient with a fixed partial denture made of an ocean shellPoljak-Guberina Renata, Čelebić Asja, Guberina Marko, Pavić Maja

Private Dental Office and School of Dental medicine, University of Zagreb, Croatia

INTRODUCTION: Except for the quality of a fixed partial denture (FPD) many other factors are also related to patient's satisfaction. Satisfaction seems to have a multicausal character and patient related factors also influence the final result. Many factors related to the patient and important for their final satisfaction are well documented in the literature: patient's personality, attitude towards FPD and the patient's motivation (1-4). The success of prosthodontic treatment, however, is often judged differently by dentists and patients (5-7).

AIM OF PRESENTATION: This is a case report of a patient who was not satisfied with her 6 previous FPDs over a period of 10 years. She had made 6 FPDs of different materials (Pd-Ag + acrylic veneer, Au alloy + acrylic veneer, Au-Pt + isosit veneer, NiCr ceramic bridge, targis-vectris bridge, acrylic removable partial denture with golden clasps) previously. The patient complained that none of the FPD materials was healthy (she considered herself a specialist in alternative medicine and healthy life). She complained of a headache, a progression of her sight impairment, diplopia, dry and burning mouth, thirsting, pain in medial eye corners and the loss of taste and coughing. Hydrothermal ceramic FPD had been suggested to her, but after she had received her new FPD, she continued with complaints and did not allow it to be fixed permanently.

PATIENT PROGRESS: The patient then suggested to her dentist a new FPD to be made from Filipina ocean shell (Figure 1). After she was rejected, she bought herself an equipment for dental technicians. She also had a cast of her status in the mouth (prepared abutments), which she had obtained after she had received one of her previous FPDs. Following 3 months she was busy drilling a sea shell and adjusting it to the cast. Then she came to a dental office with her “masterpiece” asking her dentist to fix it permanently in her mouth. After thorough consultation about the shell composition and possible harmful effects, it was decided to fix it temporarily. However, nor the color was satisfying (too white), not the fit and the shape (Figure 2). Contrary to dentist’s opinion the patient was very satisfied, with no complaints and she even reported that she does not need reading glasses any more. She kept temporarily fixed FPD during a period of one and a half year, meanwhile the material became porous until it was finally dissolved and the construction was broken down (Figure 3). Afterwards, the patient didn’t want a new FPD of any other material and she continoued with a construction of another FPD from a new Filipina ocean shell. The problem is that the shell glaze has to be removed through the shaping procedure. At the present time she has finished her new FPD. She asked a dentist to make a pure gold construction, which she veneered with the ocean shell material (Figure 4 A and B). Figure 5. shows how a new ocean shell construction looks in the patient’s mouth. The question should be arisen: “What to do if a patient like above described one comes into your office?”

Figure 1. Filipina ocean shell Figure 2. Patient with a FPD which she hadprepared herself from an ocean shell Figure 3. FPD porous and dissolved after one and

a half year in oral cavity

A

B

Figure 4 A and B. A pure gold construction, veneered with the ocean shell material Figure 5. A new pure gold/ocean shell

construction

LITERATURE:

1. Celebic A, Knezovic-Zlataric D, Papic M, Carek V, Baucic I, Stipetic J. Factors related to patient satisfaction with complete denture therap. J Gerontol A Biol Sci Med Sci. 2003;58(10):M948-53.

2. Celebic A, Knezovic-Zlataric D. A comparison of patient's satisfaction between complete and partial removable denture wearers. J Dent. 2003;31(7):445-51.

3. Knezovic Zlataric D, Celebic A, Valentic-Peruzovic M, Jerolimov V, Panduric J. A survey of treatment outcomes with removable partial dentures. J Oral Rehabil. 2003;30(8):847-54.

4. Knezovic Zlataric D, Celebic A, Valentic-Peruzovic M, Celic R, Filipovic-Zore I, Baucic M. The satisfaction with the removable partial denture therapy in the Croatian adult population. Coll Antropol. 2000;24(2):485-94.

5. Knezovic Zlataric D, Celebic A. Treatment outcomes with removable partial dentures: a comparison between patient and prosthodontist assessments. Int J Prosthodont. 2001;14(5):423-6.

6. Celebic A, Valentic-Peruzovic M, Stipetic J, Delic Z, Stanicic T, Ibrahimagic L. The patient's and the therapist's evaluation of complete denture therapy. Coll Antropol. 2000;24 Suppl 1:71-7.

7. Stipetic J, Celebic A, Jerolimov V, Vinter I, Kraljevic S, Rajic Z. The patient's and the therapist's evaluation of bridges of different materials and age. Coll Antropol. 2000;24 Suppl 1:25-9.