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Patients with a missing tooth along with diastema have limited treatment options to restore the edentulous space. The use of a conventional fixed partial denture (FPD) to replace the missing tooth may result in too wide anterior teeth leading to poor esthetics. The diastema resulting from the missing central incisors can be managed with implant-sup...
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... Diastema associated with tooth length and with discrepancy are often 4 challenging to treat. Maintaining diastema during prosthetic rehabilitation is a good option in some cases where the entire closure of 5 diastema may not give predictable aesthetic results. The present case report describes the aesthetic rehabilitation of missing maxillary anterior teeth by a combination of prosthodontic and surgical approaches. ...
... The teeth adjacent to the ridge defect should have an adequate zone of keratinized gingiva and shallow pocket depth 1 for the success of the augmentation. Prosthetic management of the defect with the use of gingival porcelain would give the appearance of a long tooth with over contoured pontics, which looks obvious in cases 4,5 of a high lip line. Also, the bulk adds to the weight of the prosthesis. ...
Ridge defect can be due to consequences of trauma or after extensive tooth extraction periodontal disease, apical pathology or developmental anomalies. This case report describes the aesthetic rehabilitation of missing maxillary anterior tooth with diastema using combination of surgical, prosthodontic and digitalized approach. Bone graft was used to repair a ridge defect along with connective tissue ap for soft tissue augmentation in the anterior maxilla. After healing period of 6 weeks, soft and hard tissue was assessed and fabrication of loop connector was started using digitalized approach. The loop connector was decided to maintain the diastema hence giving natural appearance. Digitalized approach was focused for a better smile design and more precise adaptation of prosthesis.
... Various treatment options are available for the replacement of a single anterior tooth that includes an implant-supported prosthesis, resin bonded prosthesis or conventional fixed partial denture (FPD). [2] This leaves a challenge for prosthodontists whether to close the space or to maintain the space with restoration simulating natural appearance. [3,4] If diastema has to be maintained in restoration and implant is not a treatment option, FPD along with loop connector is the best treatment option since the conventional FPD may result in too wide anterior teeth or an over-contoured emergence profile. ...
The malnutrition is pervasive are in the Itang special district of Gambella region. The children, elder, pregnant women, disabilities and other disadvantageous members of the households were extremely malnourished in the district. The main aim of this study was to assess dietary diversity and the rural households’ nutrition security in Itang special district. The study was carried out in Itang Special District among the rural households. It had collected the primary data through households’ consumption survey, key informants interview and body mass index. Then, the descriptive statistics mainly frequency and percentage were used to analyze the data via SPSS version 20. The field result revealed that about 54%, 40% and 6% of the rural households have low, medium and high dietary diversity in the district. Similarly, about 53%, 35%, 5% & 7% of the rural households were underweight, normal, obese & overweight respectively in the district. There was a low dietary diversity and high prevalence of underweight among the rural households in the study district. Thus, the Office of Agriculture and Natural Resources of the district, together with the health office have to provide the capacity building training on awareness of diversification of the income sources and credits facilities in Itang special district.
... Edwards JG in his research concluded that in patients with generalized spacing and diastema greater than 2 mm; the chances of reducing the spacing with normal development of In cases where orthodontic space correction is not feasible, then non-conventional fixed partial denture (FPD) prosthesis is planned. However, the final esthetic result of treatment plan should be contemplated carefully before the closure of the diastema with the final fixed partial denture [4,8]. ...
Increased mesiodistal space after loss of an anterior tooth in patients with existing diastema often presents with a dilemma in
restoration of teeth in the esthetic zone. In patients with existing anterior diastema, restoration of loss of an anterior tooth can be
quite challenging. Closure of space with orthodontic correction is time consuming. Restoration of anterior tooth along with soft and
hard tissue loss calls for various treatment modalities such as implants, removable partial denture and conventional fixed partial
dentures. Often the latter treatment plan does not come across as an esthetic treatment option so non conventional fixed partial dentures such as loop connectors are the preferable treatment choice. In the case report presented here, two missing anterior teeth had
to be restored in a patient with generalised diastema. So a five unit fixed partial denture prosthesis with loop connector was planned.
Keywords: Mesiodistal Space; Diastema; Loop Connector
... [11], [12] The speech of the patient may get affected if the connector design is bulky, in turn affecting the linguopalatal sounds. [13] Therefore, it must be used only as an interim mode of treatment in cases where skeletal growth is not completed, or during the osseointegration phase before implant loading, or during the healing of the periodontium until a permanent prosthesis can be given. Furthermore, strict oral hygiene instructions must be given to prevent plaque accumulation around the loops. ...
To tackle a large midline diastema and generalized spacing existing before extraction often poses a challenge to the treating prosthodontist. The situation becomes even more complicated if the patient is a teenager, with multiple missing teeth, associated deep bite and where the jaw bone growth has not yet been completed. Possible treatment options would include a removable prosthesis, a fixed partial denture or an implant supported prosthesis. Treating such cases with a simple removable prosthesis cannot be justified if a deep bite existed which would result in posterior disocclusion. Also a conventional fixed partial denture or closure of the diastema with light cure composite (LCC), would result in a seemingly large tooth, which would be unaesthetic in appearance. Implant supported prosthesis is a possibility, if the patient's jaw bone growth has been completed. Another simple non-invasive solution to this problem would be to fabricate a non-rigid connector using loops. This presentation describes the procedure for fabrication of an interim loop connector for a 16 year old female patient who had lost one of her maxillary central incisors as a result of trauma. Patient also had multiple spacing in the maxillary anterior teeth and an associated deep bite. Her cephalogram revealed that she had a Class III skeletal pattern. A permanent treatment at this stage was not possible due to ontoward mandibular growth pattern as revealed on the cephalogram. Hence to dodge all these problems, a simple and non-invasive treatment using loop connectors was chosen till the growth period was completed.
... The FPD with loop connectors enhance the natural appearance of the restoration and help maintaining the spacing. 1 The appearance of the gingival tissues surrounding the teeth also plays a critical role in anterior aesthetics. The gingival perspective is concerned with the soft tissue envelope surrounding the teeth. 2 Tissue graft surgeries may be essential to improve the aesthetic profi le in edentulous spans prior to prosthetic rehabilitation. ...
... 4 The modified FPD with loop connectors enhance the natural appearance of the restoration, maintain the inter-tooth spacing and preserves the remaining tooth structure of the abutment teeth. 1 Connectors are the part of FPD that connect between retainer and pontic. They may be either rigid or non-rigid. ...
Esthetic Rehabilitation of Siebert's Class II Case with Loop Connectors and Connective Tissue Graft
... Use of loop connectors in mandibular arch as in present case usually does not affect the speech. 9,10 If the patient can get adapted to the palatally/lingually projecting connector, incorporation of loop connector is an excellent treatment option in cases where excessive space is present in the esthetic zone. 11 There are many reports in literature that describe maxillary loop connectors in fixed partial dentures. ...
Connectors are the components of fixed dental prosthesis that join the individual retainers and pontics together. Connectors may be rigid or nonrigid. Loop connector is a type of rigid connector, indicated primarily when an existing diastema is to be maintained in a planned fixed prosthesis. Such cases can be treated with an implant supported prosthesis or a fixed prosthesis using a loop connector. In case of loop connector, the connector is in the form of a loop on the lingual aspect of the prosthesis that connects the adjacent retainer and pontic. Similarly, loop connector can also be used in the mandibular anterior region for replacement of central incisors, using canines as abutments rather than mandibular laterals which usually have compromised bone support.
There are many reports in literature describing the use of a loop connector in the maxillary anterior sextant. But, there are seldom reports about the use of a loop connector in the mandibular anterior region. This case report describes the use of a mandibular loop connector for the replacement of mandibular teeth where the adjacent teeth are periodontally compromised.
How to cite this article
Kore AR, Kore S, Gosavi S, Tewari S, Gosavi S, Sanyal P. Mandibular Loop Connector: An Underrated Treatment Modality. World J Dent 2015;6(3):184-187.
... Loss of an anterior tooth with existing diastema may result in the excess space available for pontic. 1 In such a clinical situation, the options available for replacement of single anterior tooth are removable partial denture, implant supported prosthesis or conventional fixed dental prosthesis. 2 During history taking, patient's medical, social and drug history were non-significant, whereas dental history revealed avulsion of mandibular left central incisor due to blunt trauma from ball injury two years ago. The avulsion injury also resulted in the mesial migration of the tooth 41 resulting in the shift of the mandibular midline to the left side. ...
Loss of anterior teeth in patients with diastema presents a great esthetic challenge for the prosthodontists. In cases with midline diastema and interdental spacing, the option of a conventional fixed partial denture becomes impossible to use. This is because of the excess space available for pontic, which makes the incorporation of the diastema in the planned prosthesis, a compulsion. Diastema closure in such cases with the help of conventional fixed partial denture is bound to result in esthetic failures. This article presents a case of midline diastema successfully maintained by lingual loop connectors between the pontic and the retainers to achieve esthetic rehabilitation in the mandibular anterior region.
... Higher strength of resin cements have also allowed resin bonded to be used with multiple loop connectors. [15,16,17] The design selected in this case too was largely due to the presence of a favorable occlusion. Clinical evaluation of occlusion when designing such prosthesis should exclude the presence of excursive contacts at the margins of the retainer with the tooth. ...
Spacing between natural teeth is considered as a normal characteristic of class 1 malocclusion which is due to its high prevalence. However, spacing in the midline of the natural dentition has always been an area of interest for a prosthodontist. The challenge is so severe that most of the times its incorporation is part of treatment plan rather than any attempt to eliminate it, because midline diastema closure with a fixed prosthesis usually results in esthetic failures. With advances in dental cements especially resin cements; there has been an increase in delivery of resin bonded prosthesis, but has not been explored for possibility of maintaining midline diastema. This article presents a case of midline diastema successfully maintained by resin bonded prosthesis through the use of a loop connector between the pontic and the retainer.
... Maximum esthetic results is obtained if the natural anatomic forms of teeth are protected and the diastema are maintained with minimal over-contouring of the adjacent teeth [4]. The modified FPD with loop connectors enhance the natural appearance of the restoration, maintain the diastemas and the proper emergence profile and preserve the remaining tooth structure of the abutment teeth [5]. The prosthesis design may cause difficulty in maintenance and may effect in phonetics especially linguopalatal sounds. ...
... The prosthesis design may cause difficulty in maintenance and may effect in phonetics especially linguopalatal sounds. However keeping the connectors round and small in size will not affect the phonetics [5]. Photoelastic analysis has revealed that within the connector, the highest stress was found at the gingival region of the connector and the lowest in the middle of the connector [6,7]. ...
A case of patient with missing tooth in the upper anterior region of the jaw reported to our institution with generalized spacing. The use of conventional FPD may result in too wide anterior teeth leading to poor esthetics. Hence modified FPD with loop connectors provide natural appearance of the restoration and also preserve the remaining tooth structure of abutment teeth. This clinical report deals with the treatment using modified FPD with loop connectors to retain the diastemas while replacing the missing teeth in the maxillary aesthetic zone.
Rehabilitation of a missing tooth with a Fixed Dental Prosthesis is a commonly used treatment option with proven clinical results and longevity. Recreating good proximal contacts is the key to successful rehabilitation. However, in clinical situations where a certain amount of diastema may be desired by the patient or deemed necessary by the clinician to achieve esthetic treatment, use of loop connectors is necessary. Digital evaluation of the tooth material arch length discrepancy and following esthetic proportions like golden percentage ensures a well planned treatment procedure and a more predictable treatment outcome. This case report highlight rehabilitation of a missing anterior tooth in esthetic zone utilizing digital planning software and using loop connector to maintain esthetics. The intent of this case is to highlight loop connector as a viable treatment option for maintenance of diastema in cases where desired and the use of simple, commonly available software to implement esthetic proportions in designing of restorations.
