1. fixed partial denture finals1


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1. fixed partial denture finals1

  3. 3. 1. SIMPLE FIXED BRIDGE <ul><li>A. Rigidly Fixed Bridge </li></ul><ul><li>-permits no individual or independent movements of its parts and is also known as STATIONARY FIXED BRIDGE </li></ul>
  4. 4. <ul><li>B. Semi –Fixed Bridge </li></ul><ul><li>-one which allows some individual or separate movements of some of its parts and is also known as LIMITED STATIONARY / BROKEN STRESS BRIDGE </li></ul>
  5. 5. <ul><li>C. Cantilever Bridge </li></ul><ul><li>-one which has one or more abutments at one end of the bridge while the other end is unsupported </li></ul>
  6. 6. 2. COMPOUND FIXED BRIDGE <ul><li>-a combination fixed partial denture which employs two or more of the simple type in one restoration </li></ul>Rigidly fixed bridge
  7. 7. SUBCLASSIFICATION ACCORDING TO LOCATION <ul><li>A. Anterior or Labial Bridge </li></ul><ul><li>- Limited to incisor region </li></ul><ul><li>B. Posterior or Buccal Bridge </li></ul><ul><li>- from canine posteriorly to include premolars and molars </li></ul><ul><li>C. Combination Antero-Posterior Bridge or Labio-Buccal bridge </li></ul><ul><li>- includes anterior and posterior teeth </li></ul>
  9. 9. 1. Abutment <ul><li>It is the selected remaining tooth or teeth where a crown or a bridge is attached </li></ul>
  10. 10. 2. Retainer <ul><li>It is the artificial crown or crowns used to attach the bridge to the abutment tooth/teeth. </li></ul>
  11. 11. 3. Pontic <ul><li>artificial crown used to restore the missing tooth or teeth in the arch and may either be: </li></ul><ul><li>all porcelain; </li></ul><ul><li>porcelain fused to metal; plastic attached to metal; and all plastic </li></ul>
  12. 12. 4. Connector <ul><li>Serves to connect retainer on one side to the other retainer on the other side of the bridge as well as unites all the other parts of the bridge </li></ul>
  14. 14. A. Abutment <ul><ul><ul><li>with vital pulp </li></ul></ul></ul><ul><ul><ul><li>with normal amount of periodontal attachment </li></ul></ul></ul><ul><ul><ul><li>capable of supporting additional forces to which it will be subjected as part of the FPD </li></ul></ul></ul>
  15. 15. <ul><ul><ul><li>its preparation must be such that its retentive power shall be sufficient to resist the displacing forces to which it will be exposed </li></ul></ul></ul>
  16. 16. B. Retainer <ul><ul><li>- must be so designed that it has sufficient strength </li></ul></ul><ul><ul><li>- margins prevent irritation of the soft tissues and recurrence of caries </li></ul></ul><ul><ul><li>- must be self-cleansing </li></ul></ul>
  17. 17. <ul><ul><li>- does not corrode or tarnish </li></ul></ul><ul><ul><li>- does not discolor </li></ul></ul><ul><ul><li>- it is aesthetic </li></ul></ul>
  18. 18. C. Pontics <ul><li>-restore the function of the tooth it replaces </li></ul><ul><li>-meet the demands of esthetics and comfort </li></ul><ul><li>-be biologically acceptable to the tissues </li></ul><ul><li>- ensure its sanitation </li></ul><ul><li>-prevent tissue inflammation of underlying residual ridge mucosa </li></ul>
  19. 19. 4. Connector <ul><li>connector should be approximately 2mm. in size </li></ul><ul><li>Connector should always pass through what would be normal contact area of teeth being replaced </li></ul><ul><li>allows for creation of normal embrasures and interdental spaces </li></ul>
  20. 20. <ul><li>Incisal/occlusal surface of connector should never have sharp edge, which presents cleavage point to porcelain </li></ul><ul><li>Connector should be contoured interproximally to allow for equal porcelain coverage on adjoining teeth </li></ul>
  21. 21. Proper placement of connector in the anterior and posterior teeth
  22. 22. <ul><li>Characteristics: </li></ul><ul><li>All surfaces should be convex, smooth and properly finished </li></ul><ul><li>The occlusal table must be in functional harmony with the occlusion of all the teeth </li></ul><ul><li>The overall length of the buccal surface should be equal to that of the adjacent abutments/pontic </li></ul>Anterior and Posterior Pontic Design
  23. 23. <ul><li>The lingual contour should be in harmony with adjacent teeth or pontics </li></ul>
  24. 24. Factors Influencing Fixed Bridge Design
  25. 25. <ul><li>1. Crown Length </li></ul><ul><li>-teeth must have adequate occlusocervical crown length to achieve sufficient retention </li></ul>
  26. 26. <ul><li>2. Crown Form </li></ul><ul><li>- some teeth have tapered crown form which interferes with parallelism </li></ul><ul><li>- incisors possessing very thin highly translucent incisal edges </li></ul>
  27. 27. <ul><li>3. Degree of Mutilation </li></ul><ul><li>- size, number and location of carious lesions or restorations affect whether full or partial coverage retainers are indicated </li></ul><ul><li>- fractured or carious teeth not restorable should be removed thereby altering design and creating the need for a prosthesis </li></ul>
  28. 28. <ul><li>4. Root Length and Form </li></ul><ul><li>- roots with parallel sides and developmental depressions are better able to resist additional occlusal forces than are smooth-sided conical roots </li></ul><ul><li>- multirooted teeth generally provide greater stability than single-rooted teeth </li></ul><ul><li>- longer root has better retention than short root </li></ul>
  29. 29. <ul><li>5. Crown-Root Ratio </li></ul><ul><li>- 1:1.5 ratio has been generally acceptable whereas 1:1 ratio is considered minimal and requires consideration of other factors (ex. # of tth being replaced, tooth mobility, periodontal health) before it can be used as an abutment </li></ul>
  30. 30. <ul><li>6. Ante’s Law </li></ul><ul><li>- periodontal ligament area/pericemental area of the abutment teeth should be equal or greater than the periodontal ligament area/pericemental area of the missing tooth/teeth </li></ul>1
  31. 31. <ul><li>7. Periodontal Health </li></ul><ul><li>- absence of any form of periodontal disease such as bone resorption and gingival recession </li></ul>
  32. 32. <ul><li>8. Mobility </li></ul><ul><li>– MILLER MOBILITY VALUE </li></ul><ul><li>1 o mobility – normal </li></ul><ul><li>2 o mobility – still acceptable provided that you must know the factor that cause the mobility (px age, presence of calcular deposit) and consider the # of tth being replaced </li></ul><ul><li>3 o mobility – can not be used as an abutment/for extraction </li></ul>
  33. 33. <ul><li>9. Span Length </li></ul><ul><li>-distance between abutments affects the feasibility of placing fixed prosthesis </li></ul><ul><li>- ideal for 1-2 missing tth </li></ul><ul><li>- loss of 3 adjacent tth requires careful evaluation of other factors (crown-root ratio, root length and form, periodontal health, mobility) </li></ul>Primary abutment Secondary abutment
  34. 34. <ul><li>10. Axial Alignment </li></ul><ul><li>- crowns of proposed abutments must be well aligned </li></ul><ul><li>- minor alterations in axial alignment (tipped/rotated) often necessitate the use of full coverage crowns to achieve retention or acceptable esthetics </li></ul>
  35. 35. <ul><li>11. Arch Form </li></ul>fulcrum line fulcrum line lever lever counter-balancing
  36. 36. <ul><li>12. Occlusion </li></ul><ul><li>- occlusal forces brought to bear on a prostheses are related to the ff: </li></ul><ul><li>a. degree of muscular activity </li></ul><ul><li>b. patients habit </li></ul><ul><li>c. # of tth being replaced </li></ul><ul><li>d. leverage on the bridge </li></ul><ul><li>e. adequacy of bone support </li></ul>
  37. 37. <ul><li>13. Pulpal Health </li></ul><ul><li>- abutment/s should not be sensitive to percussion or vitality testing </li></ul><ul><li>- abutments with poor pulpal health should undergo endodontic tx prior to tooth preparation </li></ul>
  38. 38. <ul><li>14. Alveolar Ridge Form </li></ul><ul><li>- not indicated for FPD if there is considerable bone loss </li></ul>Vertical bone loss Horizontal bone loss
  39. 39. <ul><li>15. Age of Patient </li></ul><ul><li>- not indicated in older patient as well as adolescents when teeth are not fully erupted or with large pulps </li></ul>
  40. 40. <ul><li>16. Phonetics </li></ul><ul><li>- patients prefer FPD for good phonation (provides sufficient resistance to the flow of air to allow normal speech sounds to be produced) rather than RPD </li></ul>
  41. 41. <ul><li>17. Long-Term Abutment Prognosis </li></ul><ul><li>- take note of the oral hygiene </li></ul><ul><li>-if there is question on the ability of the remaining supporting structure to accept additional occlusal forces, RPD is indicated </li></ul><ul><li>- tooth with sufficient loss of periodontal support and questionable prognosis may be best treated with an RPD rather than an FPD </li></ul>
  42. 42. <ul><li>18. Esthetics </li></ul><ul><li>-prefer FPD because it resembles natural tooth </li></ul><ul><li>-but RPD may be indicated when the use of a pontic produces large and unsightly proximal embrasures in a fixed prostheses. </li></ul>
  43. 43. <ul><li>19. Psychological Factors </li></ul><ul><li>- to most pxs an FPD feels more normal than an RPD and more quickly becomes an accepted part of the oral environment </li></ul><ul><li>- px feels more confident and looks good wearing FPD than RPD </li></ul>