Abstracts Proceedings

Event: 15th Scientific Conference and AGM of Malaysian Association for Prosthodontics (MAP) Theme: From Basic to Brilliance Date: 4th to 5th July 2025 Venue: Courtyard by Mariott Kuala Lumpur South. From Ridge Deficiency to Aesthetic Excellence: Biologically and Prosthetically Driven Single Anterior Tooth Implant Rehabilitation – A Case Report Loshni S. Sagaran, Eshamsul Sulaiman Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia Rehabilitating a missing tooth in the anterior maxilla presents significant aesthetic and biological challenges, especially in cases with hard tissue deficiency and a thin, soft tissue phenotype. This case describes an implant-supported rehabilitation of a missing maxillary lateral incisor (tooth 12) following orthodontic space creation, ridge augmentation, and soft tissue optimisation. Initial CBCT revealed inadequate labio-palatal ridge width. Horizontal ridge augmentation was performed using a sandwich grafting technique with tenting screws to maintain space and protect the graft. Autogenous bone and allograft mix was placed on the ridge, followed by a layer of xenograft to enhance volumetric stability and covered by a resorbable collagen membrane. Implant positioning was digitally planned using a prosthetically and biologically driven approach via R2GATE software. Through a fully guided protocol, a 3.75 × 8.5 mm MegaGen BlueDiamond implant was placed 4mm from the future free-gingival margin with 2mm of labial bone remaining. Connective tissue augmentation using a de-epithelialized free gingival graft was placed via a tunnelling technique to enhance peri-implant mucosal thickness and buccal contour. A chairside implant provisional crown with optimum emergence profile was fabricated to support the transmucosal soft tissue maturation. Definitive rehabilitation involved a CAD/CAM-fabricated zirconia abutment and a high-aesthetic zirconia crown. A cement-retained design was selected to preserve incisal aesthetics as the axis of the implant was through the incisal edge due to anatomical limitations. Special care was taken during cementation to prevent extrusion of cement into the transmucosal space. Treatment resulted in excellent peri-implant soft tissue integration with the implant-supported crown and a stable marginal bone level. The patient reported high satisfaction with function and aesthetics. This case highlights the importance of integration of biologically and prosthetically driven implant placement to achieve predictable aesthetic and long-term stability of peri-implant tissue in a single anterior implant rehabilitation. PEEK into the Future of Overdentures Elevating Overdentures: The PEEK Revolution Nadiyah Abdullah Zawawi1, Melati Mahmud2 1Restorative Dentistry Specialist Unit, Kota Setar Dental Clinic, Alor Setar, Kedah, Malaysia 2Centre for Restorative Dentistry Studies, Faculty of Dentistry, UiTM, Sg Buloh, Selangor, Malaysia Implant-retained overdentures are a well-established option for patients with severe mandibular ridge resorption, significantly improving function and quality of life. The McGill and York consensus statements endorse two-implant retained overdentures as the standard of care for edentulous mandibles. This clinical report presents the prosthodontic rehabilitation of a healthy 57-year-old Malay female patient with ill-fitting maxillary and mandibular complete dentures, with primary concern regarding mandibular denture instability. Clinical examination revealed a knife-edge maxillary ridge and palatal erythema. The treatment aimed on improving aesthetics and function with retentive denture for the patient. A new acrylic maxillary complete denture was then fabricated, while the mandible was restored with an implant-retained overdenture supported by two endosseous implants in regions tooth 33 and 43 (⌀ 3.3 mm × 10 mm, BLT Straumann®, Switzerland). The Straumann® Novaloc® attachments were used as abutments. The Novaloc® attachment system offers a reliable alternative to conventional Locator® attachments, delivering comparable retention. The system’s PEEK retentive inserts demonstrate reduced wear compared to traditional nylon, enhancing long-term performance and durability. The patient expressed high satisfaction with the improved mastication and aesthetics. This treatment approach significantly enhanced denture retention and stability, resulting in improved function and overall appearance. Construction of a Custom Ocular Prosthesis with Surgical Deepening of the Inferior Fornix: A Case Report Jana Abdulla, Nor Aidaniza Abdul Muttlib Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia Rehabilitation of an anophthalmic socket following enucleation, particularly in paediatric retinoblastoma cases, demands a multidisciplinary approach to restore both function and facial symmetry. This case report presents a comprehensive strategy combining surgical and prosthodontic interventions to address chronic discomfort and poor prosthesis retention caused by inadequate inferior fornix depth. A two-stage protocol was employed, beginning with a diagnostic impression using a modified duplicate denture technique to capture the socket’s anatomy. This guided the fabrication of a surgical-grade polymethyl methacrylate (PMMA) conformer for postoperative stabilization. Subsequent surgical deepening of the inferior fornix was performed to optimize the anatomical foundation for prosthetic retention. Three weeks post-surgery, a custom ocular prosthesis was fabricated, tailored to the refined socket contours. The intervention resulted in marked improvements in prosthetic fit, patient comfort, and aesthetic outcome. This case underscores the critical role of inferior fornix deepening in managing complex anophthalmic sockets and highlights the synergy between surgical precision and prosthetic customization in achieving long-term rehabilitation success. Integrative Biologically and Prosthetically Driven Implant Therapy for Long-term Peri-implant Tissue Stability – A Clinical Case Report Chung Yee Shien, Eshamsul Sulaiman Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia Prosthetically driven implantology alone cannot guarantee stability of peri-implant tissue over long-term with subsequent risk of marginal bone loss and soft tissue dehiscence. Adequate crestal bone thickness is required to maintain facial marginal bone level. In addition, adequate supra-crestal soft tissue thickness and keratinised mucosal width are required to minimise crestal bone remodelling and support the development of a favourable emergence profile, contributing to long-term aesthetic outcome. This case report presents an integration of biologically and prosthetically driven implant dentistry, aimed at optimising long term hard and soft tissue stability around dental implant and its functional stability. Clinically the patient presented with thin gingival phenotype with soft tissue deficiency buccally at a missing tooth 46 area. To enhance soft tissue thickness, an epithelialised-connective tissue graft was harvested from the palate, de-epithelialised extra-orally, and placed underneath the buccal flap during subcrestal implant placement. Surgical procedure was carried out under local anesthesia with full-thickness flap elevation and subcrestal implant placement using surgical guide, following both the manufacturer’s recommendations and pre-established implant planning protocol. Healing abutment was connected to support buccal folding flap during tissue healing. Subcrestal implant placement aimed to achieved 4mm vertical soft tissue thickness. At the 6-month follow-up, a favourable emergence profile and increased soft tissue thickness was established. This profile was captured using a customised transfer coping with flowable composite resin and putty silicone. The final restoration consisted of a CAD-CAM titanium abutment and cement-screw retained zirconia crown. Occlusion was carefully managed, with light contact centered at occlusal fossa and occlusal forces limited to static contact, avoiding lateral interferences. This integrated biologically and prosthetically driven approach emphasises the importance of soft tissue management in maintaining peri-implant tissue health and functional stability for long-term implant and prosthesis success. Prosthodontic Rehabilitation in a Medically Compromised Patient Using Cu-Sil Dentures and the Scandinavian Approach Nordin Khairini, Siti Fauzza Ahmad, Lim Ghee Seong Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia Prosthodontic care in medically compromised patients requires a conservative, biologically respectful approach to preserve function and minimize risk. This case report details the prosthodontic rehabilitation of a patient with metastatic cervical cancer, utilizing Cu-Sil dentures and the Scandinavian prosthodontic philosophy to address systemic and intraoral complexities. A 67-year-old female undergoing chemotherapy and anticoagulant therapy for metastatic cervical squamous cell carcinoma presented with ill-fitting dentures. Examination revealed Kennedy Class I partial edentulism, mobile mandibular anterior teeth (Grade I–II), generalized gingivitis, and a knife-edge mandibular ridge. Due to systemic frailty, surgical options were contraindicated. A maxillary Cu-Sil denture was chosen to preserve natural teeth using silicone gaskets, maintaining proprioception and retention. The mandibular prosthesis followed the Scandinavian approach, focusing on plaque control, periodontal health, and minimal complexity. A selective pressure impression with wax spacers managed the thin mandibular ridge, while a double-bar splint stabilized mobile anterior teeth. Wrought wire clasps were used on compromised abutments to reduce stress. The prostheses exhibited good retention, tissue adaptation, and occlusion. The patient reported improved mastication, nutrition, speech, and morale. At one- and two-month reviews, no signs of trauma, instability, or worsening periodontal health were noted. Oral hygiene was maintained effectively due to the design’s simplicity and biological compatibility. This case highlights the effectiveness of combining Cu-Sil dentures with the Scandinavian approach for minimally invasive, functionally stable prosthodontic rehabilitation in medically compromised patients. The treatment enhanced oral health and quality of life without surgical intervention, making it a practical option in palliative dental care. Functional and Aesthetic Considerations in Mandibular Co-Cr Denture Design Suhaenih Budin, Lim Ghee Seong Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia This case report describes the prosthodontic rehabilitation of a 64-year-old Malay female patient presented with a chief complaint of a loose maxillary denture, which had become unstable following recent extractions of the upper posterior teeth. She had previously discontinued using a mandibular denture because of discomfort and was initially reluctant to get a replacement, fearing it would still be intolerable. The clinical examination revealed an edentulous maxilla and a Kennedy Class I mandibular partially dentate arch, characterized by spaced anterior teeth and mobility of tooth 31. A comprehensive treatment plan was developed, involving fabrication of a new maxillary complete denture and a mandibular cobalt-chromium (Co-Cr) removable partial denture. The mandibular denture design required careful consideration of both functional and aesthetic factors, including biomechanics for free-end saddles, reduced vestibular depth, high frenal attachments, anterior spacing, and future adaptability. A customized framework incorporating RPA clasping and an interrupted lingual plate with a mesh extension lingual to tooth 31 was selected to optimize support, stability, and esthetics. The treatment outcomes were successful, demonstrating a significant improvement in the patient’s oral health–related quality of life (OHRQoL), chewing ability, and overall denture satisfaction. This case highlights the importance of individualized denture design in managing anatomical and patient-specific challenges to achieve both functional and aesthetic success. From Systemic Challenge to Functional Restoration: Comprehensive Prosthodontic Rehabilitation in a Patient with Autoimmune Disease Ammar Yaseer Bin Abdul Hakim@Abdul Khakin1,2, Nur Hafizah Kamar Affendi3, Melati Mahmud3 1Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia, 2Conservative Dentistry and Prosthodontics, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia, 3Department of Restorative Dentistry, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia This case report describes the comprehensive prosthodontic rehabilitation of a 28-year-old female patient with a complex medical background, including renal tubular acidosis, hypokalemia, and Sjögren’s syndrome. The patient presented with long-standing partial edentulism, predominantly affecting the anterior region, resulting in compromised masticatory function, reduced vertical dimension, and aesthetic concerns. Her systemic condition, associated xerostomia, and irregular dental attendance necessitated a carefully coordinated and multidisciplinary treatment approach. A reorganised occlusal scheme was implemented, incorporating an increased occlusal vertical dimension (OVD) to restore functional space and facial harmony. The maxillary arch was rehabilitated using porcelain-fused-to-metal fixed prostheses, including a fixed-fixed bridge (13–23) and cantilever bridges (15–14, 25–24). The mandibular arch was restored with a cobalt-chrome removable partial denture supported by surveyed crowns on teeth 35, 34, and 45. Interim restorations were utilised to assess patient adaptation to the altered OVD prior to definitive prosthesis delivery. Management of xerostomia included fluoride therapy, salivary substitutes, and dietary modifications tailored to the patient’s risk profile. Treatment was delivered in sequenced phases: prevention, stabilisation, provisionalisation, definitive restoration, and maintenance. Regular monitoring and patient education were emphasised throughout to enhance long-term outcomes. Upon completion of treatment, the patient demonstrated improved oral function, aesthetic satisfaction, and psychological well-being. This case highlights the importance of personalised treatment planning, interdisciplinary coordination, and phased rehabilitation in managing medically compromised patients requiring complex prosthodontic care. Functional and Aesthetic Rehabilitation of a Worn Dentition: A Multimodal Approach with Ceramic-composite Sandwich Technique Nazrin Rosli1, Noor Harliana Zohdi2, Melati Mahmud3 1Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia, 2Centre for Comprehensive Care Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia, 3Centre for Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia Tooth wear is a growing clinical challenge that often presents with functional, aesthetic, and structural deterioration. This case report outlines the full-mouth rehabilitation of a patient with long-standing posterior partial edentulism, reduced occlusal vertical dimension (OVD), and significant palatal enamel loss secondary to chronic acidic exposure from apple cider vinegar consumption. The patient also expressed aesthetic concerns related to tooth form and smile appearance. A digitally guided, reorganised occlusal scheme was established to restore the vertical dimension and ensure a predictable functional outcome. Interim composite restorations were used at the proposed increased OVD to assess neuromuscular adaptation and patient tolerance. The maxillary arch was rehabilitated using a minimally invasive approach combining palatal glass ceramic veneers and injection-moulded composite on the facial surfaces, constituting a conservative “sandwich technique” for structural and aesthetic enhancement. A fixed-fixed porcelain fused to metal bridge was constructed between teeth 13 and 15, and implant supported crown 16 to restore posterior support. In the mandible, a cobalt-chrome removable partial denture was prescribed, supported by surveyed metal-ceramic crowns on teeth 45 and 47 to enhance retention and stability. The integration of digital planning throughout diagnosis and restorative phases allowed for precise control of occlusal vertical dimension, aesthetic evaluation, and guided prosthetic execution. The result was a predictable, functionally stable, and aesthetically pleasing outcome with high patient satisfaction. This case highlights the efficacy of a digitally driven, multidisciplinary approach in managing complex tooth wear through a combination of ceramic, composite, fixed, removable, and implant-supported prosthesis. Publication Trends in Removable Partial Dentures Research from 1948 to 2022 Nor Faharina Abdul Hamid1, Farha Ariffin2, Solehudin Shuib3, Rohana Ahmad1 1Centre for Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia, 2Centre of for Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia, of of Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia The of was to and in removable partial denture from 1948 to 2022 by and the and in the were from the using the partial and were performed using and A of between 1948 and 2022 were to and The revealed a in From 1948 to on and cobalt-chromium and the a titanium was on new and with as and of as the used in outcomes. 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