Fpdarun M K

PROSTHODONTICS
Prosthodontics is the dental specialty pertaining to the diagnosis,
treatment planning, rehabilitation and maintenance of the
oral function, comfort, appearance and health of patients with clinical
conditions associated with missing or deficient teeth and/or
maxillofacial tissues using biocompatible substitutes

BRANCHES FIXED REMOVABLE MAXILLOFACIAL : Fixed : Movable : Removable COMPLETE PARTIAL : Extracoronal. : Intracoronal

ARUN M KRISHNAN ANU KRISHNA KUMAR (Final Year ,Part I ) INTRODUCTION TO FIXED PARTIAL DENTURE

Definition “ A partial denture that is luted or otherwise securely retained to natural teeth, tooth roots and/or dental implant abutments that furnish the primary support for the prosthesis”

FIXED PROSTHODONTICS .
Fixed prosthodontics pertains to the restoration or replacement of teeth with artificial substitutes that are attached to natural teeth, roots or implants and that are not readily removable .
Successful treatment – patient education, prevention of dental disease, diagnosis, periodont. therapy, operative skills, occl. Consideration, placement of removable/complete/partial prosthesis & endo.treatment.

One or two adjacent teeth are missing in the same arch.
The supportive tissues are healthy.
Suitable abutment teeth are present.
The patient is in good health and wants to have the prosthesis placed.
The patient has the skills and motivation to maintain good oral hygiene.
INDICATIONS OF FIXED PROSTHESIS.

Contraindications for a Fixed Prosthesis
Necessary supportive tissues are diseased or missing.
Suitable abutment teeth are not present.
The patient is in poor health.
The patient is not motivated to have the prosthesis placed.
The patient has poor oral hygiene habits.
The patient cannot afford the treatment.

Common Terms
CROWN
Laminate Veneers/Facial Veneers INLAY ONLAY ABUTMENT PONTIC CONNECTORS RETAINER

MATERIALS USED.
CAST METAL
METAL CERAMIC
RESIN – VENEERED
COMPLETE CERAMIC

CROWN
It is a cemented extracoronal restoration that covers or veneers the outer surface of the clinical crown.
Primary function is to protect the underlying tooth structure & restore the function, form and esthetics.
1 ) Full veneer crown. 2) Partial veneer crown. :-three quarter crowns :-reverse three-quarter crowns :-seven-eight crowns :-pinledges :-inlay :-onlay TYPES

Full Veneer Crown (cast metal)
If it covers all of the crown, the restoration is a full or complete veneer crown
It may be fabricated entirely of a gold alloy or some other untarnishable metal, a ceramic veneer fused to metal.

INDICATIONS
Teeth that have extensive coronal destructions by caries or trauma
Restoration of choice whenever maximum retention is needed
Indicated on endodontically treated teeth
Correction of occlusal plane
CONTRAINDICATIONS
If less than maximum retention and resistance is needed
Wherever intact buccal or lingual wall exists
Enameloplasty
For high esthetic needed exists like anterior teeth

Advantages
Strong
High retentive qualities
Can be modify form and occlusion
Easy to obtain adequate resistance form
Disadvantages
Removal of large amount of tooth structure
Display of metal

METAL CERAMIC CROWNS
The restorations consists of a complete coverage cast metal crown that is veneered with a fused porcelain to mimic the appearance of a natural tooth
Indications
Esthetics
Gingival involvement
If porcelian jacket crowns is contraindicated
Contraindications
Large pulp chamber
Intact buccal wall

Advantages
Superior esthetics
Retentive qualities are excellent
Disadvantages
Removal of substantial tooth structure
Fracture can occur
Difficult to obtain accurate occlusion in glazed porcelain
expensive

Partial Veneer Crown An extracoronal metal restorations that covers only part of the clinical crown is considered to be a partial veneer crown Partial Veneer Crown MOD Gold Onlay

Indications
Clinical crown of average length or longer
Intact buccal/labial surface
Well supported by sound tooth structure
Contraindications
Short teeth
High caries index
Extensive destruction
Not used in endodontically treated teeth
Poor alignment
Bulbous teeth
Thin teeth

Advantages
Conservative of tooth structure
Easy access to margins
Less gingival involvement
Verification of seating simple
Disadvantages
Less retentive than full crown
Limited adjustment of path of withdrawal
Not indicated on vital teeth

Three-quarter crowns
This type of crowns restore the occlusal surfaces and the three of the four axial surfaces but not including the facial surfaces
Three-quarter crowns for maxillary molars

Pinledge
Indications
High esthetic requirement
Undamaged anterior teeth
When proximal grooves are impossible to prepare
To alter lingual contour of maxillary anterior teeth
A partial veneer retainer preparation incorporating pins holes to provide retention

Contraindications
Large pulp
Non vital teeth
Thin teeth
carious involvement
Advantages
Minimal tooth reduction
Minimal marginal length
Minimal gingival involvement
Adequate retention
Excellent esthetics
Disadvantages
Less retentive
Techanically demanding

INLAY A fixed intracoronal restoration; a dental restoration made outside of a tooth to correspond to the form of the prepared cavity, which is then luted into the tooth Inlay may be used as a single tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions. They may be made up of gold alloy or ceramic material. Inlays are similar to fillings but the entire work lies within the cusps on the chewing surface of the tooth .

Indications
Small carious lesion
Adequate dentinal support
Low caries rate
Patient request for gold restorations
Contraindications
high caries index
Poor plaque control
MODs
Poor dentinal support require wide preparation

ONLAY A restoration that restores one or more cusps and adjoining occlusal surfaces or the entire occlusal surface and is retained by mechanical or adhesive mean It is used for restoring more extensively damaged posterior teeth needing wide mesio-occluso-distal restorations. All Ceramic Onlay

Indications
Worn or carious teeth with intact buccal and lingual cusps
MOD amalgam requiring replacements
Low caries rate
Contraindications
High caries risk
poor plaque control
Short clinical crown/extruded tooth
bruxism

Laminate Veneers/Facial Veneers
It consists of a thin layer of dental porcelain or cast ceramic that is bonded to the facial surfaces of the tooth with an appropriate resin
It is used in situations requiring an improved cosmetic appearance on the anterior tooth.

PARTS OF FIXED PARTIAL DENTURE RETAINER ABUTMENT PONTIC CONNECTOR

RETAINER Any type of device used for the stabilization or retention of a prosthesis Positioned at margin - less susceptible to caries or recurrence of caries Rigidity – withstand the requisite load Functional adaptation and protect the tooth against its fracture Least destroys the cervical marginal ridge

Types of retainer
Full veneer crowns
Partial veneer crowns
Conservative retainers
All metal retainers
Metal ceramic retainers
All ceramic retainers
All acrylic retainers

Pontics An artificial tooth on a fixed dental prosthesis that replaces a missing natural tooth, restores its function, and usually fills the space previously occupied by the clinical crown Pontics

Requirements of pontics -restore function -provide esthetics and comfort -be biologically acceptable -permit effective oral hygeine -preserve underlying residual mucosa
Material used
Metal-ceramic pontics
Resin veneered
All metal
Facings

ABUTMENT A tooth, a portion of a tooth, or that portion of a dental implant that serves to support and/or retain a prosthesis

Connectors Fixed dental prosthodontics, the portion of a fixed dental prosthesis that unites the retainer(s) and pontics Types- -Rigid connectors -Non rigid connectors -tenon mortise connectors -loop connectors -split pontic connectors -cross pin and wing connectors

Nonrigid connectors

Loop connectors Loop connectors are used for when existing diastema is to be maintained in the planned fixed prosthesis T he connector consists of a loop on the lingual aspect of the prosthesis that connects adjacent retainers and /or pontics

FUNCTIONS OF FIXED PARTIAL DENTURE
Provide proper occlusal function.
Maintain arch integrity/tooth position.
Maintain occlusal relationships.
Protect and preserve the remaining structures.

REFERENCE
Fundamentals of Fixed Prosthodontics Third edition.
Herbert.T.Shillingburg.
Theory and practice of Fixed Prosthodontics. Tylman’s
Contemporary Fixed Prosthodontics.stephen F Rosenstiel

THANKS FOR YOUR ATTENTION

Fpdarun M K

by TADANO on Jul 30, 2009

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Fpdarun M K — Presentation Transcript