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Introduction to fixed partial denture

a introductory presentation of fixed partial denture. with pictures

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Introduction to fixed partial denture

  1. 2. PROSTHODONTICS definition <ul><ul><li>Prosthodontics is the dental specialty pertaining to the diagnosis, </li></ul></ul><ul><ul><li>treatment planning, rehabilitation and maintenance of the </li></ul></ul><ul><ul><li>oral function, comfort, appearance and health of patients with clinical </li></ul></ul><ul><ul><li>conditions associated with missing or deficient teeth and/or </li></ul></ul><ul><ul><li>maxillofacial tissues using biocompatible substitutes </li></ul></ul>
  2. 3. BRANCHES FIXED REMOVABLE MAXILLOFACIAL : Fixed : Movable : Removable COMPLETE PARTIAL : Extracoronal. : Intracoronal
  4. 5. 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 to the prosthesis”- GPT
  5. 6. FIXED PROSTHODONTICS . <ul><li>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 . </li></ul>
  6. 7. FOR SUCESSFUL TREATMENT <ul><li>Meticulous attention to every details </li></ul><ul><li>patient interview diagnosis and education </li></ul><ul><li>prevention of dental disease </li></ul><ul><li>periodont. Therapy (if indicated) </li></ul><ul><li>occl. Consideration </li></ul><ul><li>Appropriate treatment plan </li></ul><ul><li>operative skills and treatment </li></ul><ul><li>follow up care </li></ul>
  7. 8. <ul><li>Usually belongs following categories following categories </li></ul><ul><li>comfort </li></ul><ul><li>social </li></ul><ul><li>function </li></ul><ul><li>appearance </li></ul><ul><li>Personal details </li></ul><ul><li>Medical history </li></ul><ul><li>Medical condition affecting treatment method, treatment plan and systemic condition </li></ul>
  8. 9. <ul><li>Dental history </li></ul><ul><li>Periodontal history </li></ul><ul><li>Restorative history </li></ul><ul><li>Endodontic history </li></ul><ul><li>Surgical history </li></ul><ul><li>Tmj dysfunction history </li></ul>
  9. 10. <ul><li>Examination </li></ul><ul><li>General examination </li></ul><ul><li>Extra oral examination </li></ul><ul><li>Tmj </li></ul><ul><li>Muscles </li></ul><ul><li>Lips </li></ul><ul><li>Intraoral examination </li></ul><ul><li>Periodontal </li></ul><ul><li>Occusal </li></ul><ul><li>Radiographic examination </li></ul>
  10. 11. <ul><li>One or two adjacent teeth are missing in the same arch or short span edentulous arches. </li></ul><ul><li>The supportive tissues are healthy. </li></ul><ul><li>Suitable abutment teeth are present. </li></ul><ul><li>The patient is in good health and wants to have the prosthesis placed. </li></ul><ul><li>The patient has the skills and motivation to maintain good oral hygiene. </li></ul><ul><li>Patient’s preference </li></ul>INDICATIONS OF FIXED PROSTHESIS.
  11. 12. Contraindications for a Fixed Prosthesis <ul><li>Necessary supportive tissues are diseased or missing. </li></ul><ul><li>Suitable abutment teeth are not present. </li></ul><ul><li>The patient is in poor health. </li></ul><ul><li>The patient is not motivated to have the prosthesis placed. </li></ul><ul><li>The patient has poor oral hygiene habits. </li></ul><ul><li>The patient cannot afford the treatment. </li></ul>
  12. 13. Common Terms <ul><li>CROWN </li></ul>Laminate Veneers/Facial Veneers INLAY ONLAY ABUTMENT PONTIC CONNECTORS RETAINER
  13. 14. CROWN <ul><li>It is a cemented extracoronal restoration that covers or veneers the outer surface of the clinical crown. </li></ul><ul><li>Primary function is to protect the underlying tooth structure & restore the function, form and esthetics. </li></ul>1 ) Full veneer crown. 2) Partial veneer crown. :-three quarter crowns :-reverse three-quarter crowns :-seven-eight crowns :-pinledges :-inlay :-onlay TYPES
  14. 15. <ul><li>Full Veneer Crown (cast metal) </li></ul><ul><li>If it covers all of the crown, the restoration is a full or complete veneer crown </li></ul><ul><li>It may be fabricated entirely of a gold alloy or some other untarnishable metal, a ceramic veneer fused to metal. </li></ul>
  15. 16. <ul><li>INDICATIONS </li></ul><ul><li>Teeth that have extensive coronal destructions by caries or trauma </li></ul><ul><li>Restoration of choice whenever maximum retention is needed </li></ul><ul><li>Indicated on endodontically treated teeth </li></ul><ul><li>Correction of occlusal plane </li></ul><ul><li>CONTRAINDICATIONS </li></ul><ul><li>If less than maximum retention and resistance is needed </li></ul><ul><li>Wherever intact buccal or lingual wall exists </li></ul><ul><li>Enameloplasty </li></ul><ul><li>For high esthetic needed exists like anterior teeth </li></ul>
  16. 17. <ul><li>Advantages </li></ul><ul><li>Strong </li></ul><ul><li>High retentive qualities </li></ul><ul><li>Can be modify form and occlusion </li></ul><ul><li>Easy to obtain adequate resistance form </li></ul><ul><li>Disadvantages </li></ul><ul><li>Removal of large amount of tooth structure </li></ul><ul><li>Display of metal </li></ul>
  17. 18. <ul><ul><li>METAL CERAMIC CROWNS </li></ul></ul><ul><ul><li>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 </li></ul></ul><ul><li>Indications </li></ul><ul><li>Esthetics </li></ul><ul><li>Gingival involvement </li></ul><ul><li>If porcelian jacket crowns is contraindicated </li></ul><ul><li>Contraindications </li></ul><ul><li>Large pulp chamber </li></ul><ul><li>Intact buccal wall </li></ul>
  18. 19. <ul><li>Advantages </li></ul><ul><li>Superior esthetics </li></ul><ul><li>Retentive qualities are excellent </li></ul><ul><li>Disadvantages </li></ul><ul><li>Removal of substantial tooth structure </li></ul><ul><li>Fracture can occur </li></ul><ul><li>Difficult to obtain accurate occlusion in glazed porcelain </li></ul><ul><li>expensive </li></ul>
  19. 20. 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
  20. 21. <ul><li>Indications </li></ul><ul><li>Clinical crown of average length or longer </li></ul><ul><li>Intact buccal/labial surface </li></ul><ul><li>Well supported by sound tooth structure </li></ul><ul><li>Contraindications </li></ul><ul><li>Short teeth </li></ul><ul><li>High caries index </li></ul><ul><li>Extensive destruction </li></ul><ul><li>Not used in endodontically treated teeth </li></ul><ul><li>Poor alignment </li></ul><ul><li>Bulbous teeth </li></ul><ul><li>Thin teeth </li></ul>
  21. 22. <ul><li>Disadvantages </li></ul><ul><li>Less retentive than full crown </li></ul><ul><li>Limited adjustment of path of withdrawal </li></ul><ul><li>Not indicated on vital teeth </li></ul><ul><li>Advantages </li></ul><ul><li>Conservative of tooth structure </li></ul><ul><li>Easy access to margins </li></ul><ul><li>Less gingival involvement </li></ul><ul><li>Verification of seating simple </li></ul>
  22. 23. Three-quarter crowns <ul><li>This type of crowns restore the occlusal surfaces and the three of the four axial surfaces but not including the facial surfaces </li></ul>
  23. 24. Pinledge <ul><li>Indications </li></ul><ul><li>High esthetic requirement </li></ul><ul><li>Undamaged anterior teeth </li></ul><ul><li>When proximal grooves are impossible to prepare </li></ul><ul><li>To alter lingual contour of maxillary anterior teeth </li></ul>A partial veneer retainer preparation incorporating pins holes to provide retention
  24. 25. <ul><li>Contraindications </li></ul><ul><li>Large pulp </li></ul><ul><li>Non vital teeth </li></ul><ul><li>Thin teeth </li></ul><ul><li>carious involvement </li></ul><ul><li>Advantages </li></ul><ul><li>Minimal tooth reduction </li></ul><ul><li>Minimal marginal length </li></ul><ul><li>Minimal gingival involvement </li></ul><ul><li>Adequate retention </li></ul><ul><li>Excellent esthetics </li></ul><ul><li>Disadvantages </li></ul><ul><li>Less retentive </li></ul><ul><li>Techanically demanding </li></ul>
  25. 26. 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 .
  26. 27. <ul><li>Indications </li></ul><ul><li>Small carious lesion </li></ul><ul><li>Adequate dentinal support </li></ul><ul><li>Low caries rate </li></ul><ul><li>Patient request for gold restorations </li></ul><ul><li>Contraindications </li></ul><ul><li>high caries index </li></ul><ul><li>Poor plaque control </li></ul><ul><li>MODs </li></ul><ul><li>Poor dentinal support require wide preparation </li></ul>
  27. 28. 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
  28. 29. <ul><li>Indications </li></ul><ul><li>Worn or carious teeth with intact buccal and lingual cusps </li></ul><ul><li>MOD amalgam requiring replacements </li></ul><ul><li>Low caries rate </li></ul><ul><li>Contraindications </li></ul><ul><li>High caries risk </li></ul><ul><li>poor plaque control </li></ul><ul><li>Short clinical crown/extruded tooth </li></ul><ul><li>bruxism </li></ul>
  29. 30. Laminate Veneers/Facial Veneers <ul><li>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 </li></ul><ul><li>It is used in situations requiring an improved cosmetic appearance on the anterior tooth. </li></ul>
  31. 32. 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
  32. 33. Types of retainer <ul><li>Full veneer crowns </li></ul><ul><li>Partial veneer crowns </li></ul><ul><li>Conservative retainers </li></ul><ul><li>All metal retainers </li></ul><ul><li>Metal ceramic retainers </li></ul><ul><li>All ceramic retainers </li></ul><ul><li>All acrylic retainers </li></ul>
  33. 34. 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
  34. 35. Requirements of pontics -restore function -provide esthetics and comfort -be biologically acceptable -permit effective oral hygeine -preserve underlying residual mucosa <ul><li>Material used </li></ul><ul><li>Metal-ceramic pontics </li></ul><ul><li>Resin veneered </li></ul><ul><li>All metal </li></ul><ul><li>Facings </li></ul>
  35. 36. ABUTMENT A tooth, a portion of a tooth, or that portion of a dental implant that serves to support and/or retain a prosthesis
  36. 37. 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
  37. 38. Nonrigid connectors
  38. 39. 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
  39. 40. FUNCTIONS OF FIXED PARTIAL DENTURE <ul><li>Provide proper occlusal function. </li></ul><ul><li>Maintain arch integrity/tooth position. </li></ul><ul><li>Maintain occlusal relationships. </li></ul><ul><li>Protect and preserve the remaining structures. </li></ul>
  40. 41. REFERENCE <ul><li>Fundamentals of Fixed Prosthodontics Third edition. </li></ul><ul><li>Herbert.T.Shillingburg. </li></ul><ul><li>Theory and practice of Fixed Prosthodontics. Tylman’s </li></ul><ul><li>Contemporary Fixed Prosthodontics.stephen F Rosenstiel </li></ul>
  41. 42. Have a nice day Keep smiling……………………