Types of bridges/fixed orthodontics courses

TYPES OF
BRIDGES
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

A fixed partial denture is defined as
“A partial denture that is cemented to natural teeth or roots which
furnish the primary support to the prosthesis”also known as bridges.
Types of bridges :
CONVENTIONAL FIXED PARTIAL DENTURES
They are the most commonly used type of fixed partial dentures. The
design involves fabrication of a fixed partial denture, which takes
support from abutments on either side of the edentulous space. The
design may vary according to the condition of the abutments but the
abutments on either side should be able to support the fixed partial
denture

CANTILEVER FIXED PARTIAL
DENTURES
cantilever fixed partial denture is
used when support can be
obtained only from one side of the
edentulous space. These dentures
have compromised support. The
abutment teeth on the supporting
side should be strong enough to
withstand the additional torsional
forces. Support can be obtained
from more than one tooth on the
same side of the edentulous
space

• Advantages.
Very conservative design especially when a single abutment is
involved.
When secondary abutments are used, parallel preparation can be
easily obtained because the abutments are adjacent to one another.
Easy to fabricate.
• Disadvantages.
Produces torquing forces on the abutment.
Cannot be used to restore long span edentulous spaces.
Minor design errors can affect the abutments in a large scale.

• SPRING CANTILEVER
FIXED PARTIAL
DENTURES
This is a special
cantilever bridge
exclusively designed for
replacing maxillary
incisors but these
dentures can support only
a single pontic. Support is
obtained from posterior
abutments (usually a
single molar or a pair of
splinted premolars).

Advantages.
Can be used for diastema cases.
Metal crown retainers that require minimal tooth
preparation, can be used in posterior teeth to replace
missing incisors.
Disadvantages.
The connector bar may interfere with speech and
mastication.
Deformation of the connector bar may produce coronal
displacement of the pontic.
There may be food entrapment under the connector bar,
which may lead to tissue hyperplasia.

FIXED FIXED PARTIAL
DENTURES The term
denotes fixed partial
dentures with rigid
connectors. The design of
these dentures is more
conventional. Since the
connectors are rigid,
there can be no
movement between the
connected components.
These are the most
commonly used fixed
partial denture designswww.indiandentalacademy.com

Advantages
The major advantages of these partial dentures
include:
Easy to fabricate
Economical design
Strong.
Easy to maintain
Robust design provides maximum retention
and strength
Helps to splint mobile abutments
Can be used for long bridges along with periodontally weak
abutments.

Disadvantages.
Since the connectors are rigid, unwanted stress and
lever forces are directly transferred to the abutment
producing considerable damage.
Requires excessive tooth preparation to achieve a single
path of placement.
Difficult to cement on multiple abutments .
Contraindicated for pier abutments

FIXED MOVABLE
PARTIAL DENTURES
It is defined as, A fixed
partial denture having
one or more non-rigid
connectors.{ GPT }
Here, a non-rigid
connector is used/
fabricated to connect the
components of the fixed
partial denture.
Commonly used non-rigid
connectors include Tenon
Mortis connectors (TMC),
loop connectors, split
pontic connectors and
cross pin and wing
connectors www.indiandentalacademy.com

Advantages.
They act like stress breakers while transmitting unwanted leverage
forces.
The abutment is pressurized only during occlusal loading.
Improves the health of the abutment.
The tooth preparations need not be parallel to one another. Each
abutment tooth can be prepared independently according to its
requirements.
Allows minor movements between thecomponents of the prosthesis..
Parts of the prosthesis can be cemented separately.
Disadvantages.
Complex design..
Prefabricated connector components are very expensive.
Difficult to maintain.
Movable parts tend to wear out under constant usage.
Cannot be used for long span bridges.
Complicated laboratory procedures.
Difficult temporisation

FIXED REMOVABLE
PARTIAL DENTURESI
REMOVABLE BRIDGES
One of the major
disadvantages of long
span fixed partial
dentures is that if one
abutment fails, the entire
prosthesis has to be
sacrificed. To overcome
this disadvantage, fixed
removable bridges were
introduced. These
dentures cannot be
removed by the patient
but can be easily
removed by the dentist.

MODIFIED
FIXED REMOVABLE
PARTIAL DENTURES
They were developed by
Andrew, hence they are
also known as Andrew's
bridge systems. These
dentures are indicated for
edentulous ridges with
severe vertical deficit.
The prosthesis consists
of a fixed component and
a removable component.

ALL METAL FIXED PARTIAL DENTURES
These dentures are fabricated using only metaL
Characteristics.
They are indicated for replacing maxillary and mandibular
posterior teeth.
They are not aesthetic.
They have the maximum strength and durability.

METAL-CERAMIC FIXED PARTIAL DENTURES
Here, metal is used to fabricate the core of the prosthesis. The
external surface is fabricated using ceramic. The metal is bonded to
ceramic chemically, mechanically and ionically.
Metal ceramic fixed partial dentures can be of two types.
In the first type, the metal is surrounded by porcelain on all the
surfaces.
In the second type the lingual and occlusal surface is formed by
metal and the labial and gingival surface is alone formed by
porcelain. These restorations are also termed as porcelain facings
or porcelain veneers.

Advantages
Aesthetically pleasing.
Stronger metal substructure.
Characterization possible with use of internal and
external stains.
Disadvantages.
Significant tooth preparation necessary .
To achieve better aesthetics, the facial margin of an
anterior restoration is often placed subgingivally, this
increases the potential for gingival destruction.
Brittle fracture can occur due to failure at the metal
ceramic junction.
More expensive.

ALL CERAMIC FIXED PARTIAL DENTURES
All ceramic partial dentures are fabricated using only
ceramic. All ceramics are less fracture resistant, hence,
they do not render as good retainers. However, alumina-
reinforced porcelains (inceram) have sufficient strength
to be used as good retainers.
Advantages.
Superior aesthetics.
Excellent translucency.
Requires slightly more preparation of the facial surface.
The appearance can be influenced and modified by
selecting different colors of luting agent.

Disadvantages.
Reduced strength due to lack of reinforcement with
metal.
It is very difficult to obtain a well-finished margin because
the ceramic edges tend to chip easily.
These crowns cannot be used on extensively damaged
teethbecause they cannot support these restorations.
Due to porcelain's brittle nature, large connectors have to
be used, which usually leads to impingement of the inter-
dental papilla. This increases the potential for
periodontal disease..
Wear of opposing natural teeth.

ALL ACRYLIC FIXED PARTIAL DENTURES
Characteristics.
Only indicated for long-term temporary or interim
prostheses.
Can be used for making fixed periodontal splints.
Poor wear resistance.
Easy to fabricate and adjust.
Aesthetically pleasing.

VENEERS
Veneer is a layer of restoration placed over the labial
surface of a tooth. They are primarily used as aesthetic
adjuncts to discolored or fractured teeth.
Type of Veneers
Ceramic It is the most ideal veneering material when
used with metal substructure or in all ceramic
restorations.
Acrylic Tooth colored acrylic can be used with metallic
restorations as a veneer. They are not considered as a
permanent material due to poor wear resistance. Recent
advances include use of indirect composite resins as
veneer materials.

SHORT SPAN BRIDGES
These are simple fixed partial
dentures, which replace one or
two teeth, and the teeth on
either side are ideal
abutments. These dentures
are considered ideal because
they have minimal torquing
forces. For example First
molar replacement.

LONG SPAN BRIDGES
Long span bridge denotes a condition where two or more
teeth have to be replaced and more than one abutment
has to be taken for support on either side. Long span
bridges have the potential for producing more torquing
forces on the bridge and the weaker abutment.
(especially weak abutments are adversely affected)
PERMANENT OR DEFINITIVE PROSTHESIS
This term denotes all conventional fixed partial dentures
inserted as definitive or final treatment. Most fixed partial
dentures made of metal-ceramic, all metal or all ceramic
are considered permanent restorations. They are placed
at the final phase of a rehabilitative procedure.

LONGTERM TEMPORARY BRIDGES
These dentures are usually made of acrylic resin. They
are designed to be used for a few weeks to months.
Indications:
These restorations may be given for the following
conditions:
During the interim period of treatment when the patient
is undergoing extensive occlusal rehabilitation. (E.g.
Intruding a supra-erupted tooth).. In patients undergoing
periodontal therapy these restorations may be inserted
to act as splints.

FIBRE REINFORCED COMPOSITE RESIN BRIDGES
These are basically bridges, which are reinforced by a bar of glass
fibers over which indirect posterior composites are built.
Classification
Fibre reinforced composites can be classified into:
Pre-impregnated (e.g. Fibrekor, Splint-it): The manufacturer
impregnates them with the resin .
Impregnation required (e.g. Ribbond, Cpost): fibre impregnation has
to be done by the dentist.
Contra indications
It cannot be used when fluid control is not possible.
Cannot be used for long span bridges
It should be avoided in patients with para-functional habits
It should not be used opposing unglazed porcelain teeth.

RESIN-BONDED FIXED PARTIAL DENTURES
As the name implies, these are fixed partial dentures, which are
cemented onto the abutments using special resins. Basically these
dentures consist of one or more pontics supported by thin metal
retainers placed only on the lingual and/ or proximal surface of the
abutments. Retention in these prostheses relies on the adhesive
bonding between etched enamel and the metal casting (retainer).
Indications.
Retainers for fixed partial dentures for abutments with sufficient
enamel to etch for retention.
Splinting of periodontally compromised teeth. . Stabilizing
dentitions after orthodontics
Medically compromised, indigent and adolescent patients who
cannot co-operate with long sessions of therapy.
Prolonged placement of interim prosthesis to augment surgical
procedures. www.indiandentalacademy.com

Contraindications.
Patients with an acknowledged sensitivity to base metal alloys .
When the facial esthetics of abutments require improvement.
Insufficient occlusal clearance to provide 2 to 3 mm vertical frictional
retention in the axial walls. E.g. abraded teeth.
Deep vertical overbite.
Inadequate enamel surfaces to bond. E.g. extensive caries,
existing restorations.
Incisors with extremely thin facio-lingual dimensions.
Advantages.
Non-invasive to dentin with lingual andproximal tooth preparation
including occlusal rests. Decreased pulpal irritation.
Conservative with undeniable patient appeal/comfort.. Decreased
tissue irritation due to the placement of supragingival margins.
Does not require cast alterations or removable die preparation.
Reduced cost with less chair time.

Disadvantages.
Criteria for choosing the patient are not discrete.
Demanding technique and tooth preparation.
Even minor laboratory errors cannot be corrected easily.
Plaque accumulation may occur because design is
outside the dimensions of the natural tooth.
Bulky contours may be intolerable in some patients..
Patient expectations of esthetics are high.
Not ideal for replacing more than one tooth.
Graying of the incisal surfaces
Types of Resin Bonded Fixed Partial Dentures
Resin bonded fixed partial dentures can be classified
as:.
Rochette bridge, Maryland bridge, Cast mesh fixed
partial dentures, Virginia bridge.

Types of bridges/fixed orthodontics courses

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