The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Sickle scalers are dental instruments used to remove supragingival and subgingival calculus. They have either a straight or curved blade and are used with a pulling motion at a 85 degree angle to dislodge deposits from teeth. Anterior sickle scalers have a straight shank while posterior scalers have an angled shank. Hu-Friedy offers various sickle scaler designs with different handle options.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
The document discusses the biologic width, which refers to the dimensions of the soft tissue attached to the tooth coronal to the alveolar bone crest. It consists of the junctional epithelium, connective tissue attachment, and the sulcular depth, totaling approximately 2-3 mm. Violation of the biologic width by placing restorative margins too far subgingivally can lead to bone resorption, gingival recession, or hyperplasia. The document outlines techniques for assessing biologic width dimensions and various surgical or orthodontic procedures to correct violations. Maintaining at least 3 mm of distance from the restorative margin to alveolar bone is important for periodontal health.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
Dental implants can replace missing tooth roots and support replacement teeth. They are made of titanium and surgically placed in the jawbone, where they bond with the bone through osseointegration. This stable foundation allows replacement teeth to be securely attached. There are different types of implants depending on a patient's bone structure. With proper maintenance, implants can last over 20 years and avoid issues like bone loss, gum recession, and loose dentures.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
1. The document discusses fixed partial dentures (FPDs) in patients with a history of periodontitis, noting special problems that dentists face in restoring carious or missing teeth.
2. It defines FPDs and outlines various contraindications and indications for their use based on the classification of periodontal involvement.
3. Guidelines are provided for margin placement, restoration of molars with furcation invasion, and types of treatment restorations that can be used, including permanent splints.
Minor connectors are components that join parts of a removable partial denture like clasps or indirect retainers to the major connector. They transmit functional stresses to abutment teeth and stabilize the denture. Minor connectors should be rigid with sufficient bulk and located in tooth embrasures rather than on convex surfaces. They come in different designs like open construction, mesh construction, or using beads, wires, or nails to improve retention of the denture base to the framework. Proper placement and design of minor connectors are important for the support and retention of removable partial dentures.
The document discusses different types of laminate veneer preparations. Type I is called a window preparation with no incisal edge reduction. Type II, called a butt-joint preparation, involves 2 mm of incisal reduction without a palatal chamfer. Type III, or wrap-around preparation, includes 1-3 mm of incisal reduction with a 1 mm palatal chamfer to restrict angle fractures and enhance esthetics. The preparations are performed using round or tapered diamond burs to reduce enamel in a uniform and conservative manner confined to the facial surface of teeth.
Sickle scalers are dental instruments used to remove supragingival and subgingival calculus. They have either a straight or curved blade and are used with a pulling motion at a 85 degree angle to dislodge deposits from teeth. Anterior sickle scalers have a straight shank while posterior scalers have an angled shank. Hu-Friedy offers various sickle scaler designs with different handle options.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
The document discusses the biologic width, which refers to the dimensions of the soft tissue attached to the tooth coronal to the alveolar bone crest. It consists of the junctional epithelium, connective tissue attachment, and the sulcular depth, totaling approximately 2-3 mm. Violation of the biologic width by placing restorative margins too far subgingivally can lead to bone resorption, gingival recession, or hyperplasia. The document outlines techniques for assessing biologic width dimensions and various surgical or orthodontic procedures to correct violations. Maintaining at least 3 mm of distance from the restorative margin to alveolar bone is important for periodontal health.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
Dental implants can replace missing tooth roots and support replacement teeth. They are made of titanium and surgically placed in the jawbone, where they bond with the bone through osseointegration. This stable foundation allows replacement teeth to be securely attached. There are different types of implants depending on a patient's bone structure. With proper maintenance, implants can last over 20 years and avoid issues like bone loss, gum recession, and loose dentures.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
1. The document discusses fixed partial dentures (FPDs) in patients with a history of periodontitis, noting special problems that dentists face in restoring carious or missing teeth.
2. It defines FPDs and outlines various contraindications and indications for their use based on the classification of periodontal involvement.
3. Guidelines are provided for margin placement, restoration of molars with furcation invasion, and types of treatment restorations that can be used, including permanent splints.
Minor connectors are components that join parts of a removable partial denture like clasps or indirect retainers to the major connector. They transmit functional stresses to abutment teeth and stabilize the denture. Minor connectors should be rigid with sufficient bulk and located in tooth embrasures rather than on convex surfaces. They come in different designs like open construction, mesh construction, or using beads, wires, or nails to improve retention of the denture base to the framework. Proper placement and design of minor connectors are important for the support and retention of removable partial dentures.
The document discusses different types of laminate veneer preparations. Type I is called a window preparation with no incisal edge reduction. Type II, called a butt-joint preparation, involves 2 mm of incisal reduction without a palatal chamfer. Type III, or wrap-around preparation, includes 1-3 mm of incisal reduction with a 1 mm palatal chamfer to restrict angle fractures and enhance esthetics. The preparations are performed using round or tapered diamond burs to reduce enamel in a uniform and conservative manner confined to the facial surface of teeth.
This document provides guidance on the examination, diagnosis, and treatment planning process for complete denture prosthodontics. It outlines the various components of patient history taking and clinical examination that are important to assess, including medical history, extraoral examination, intraoral soft tissue and residual ridge examination, radiographs, and mental attitude assessment. Factors such as age, gender, occupation, chief complaint, systemic diseases, neuromuscular function, saliva, arch size and shape, interarch relationship, and existing dentures are evaluated. The results of this process inform the treatment plan, which is discussed with the patient, and prognosis is determined.
The document discusses gingival curettage, which involves scraping diseased soft tissue from periodontal pockets. It describes different types of curettage including surgical, chemical, ultrasonic, and laser. Indications for curettage include shallow pockets and as maintenance treatment for recurrent inflammation. Contraindications include acute infections and pockets extending beyond the mucogingival junction. The procedure involves scraping the pocket wall with a curette. Excisional new attachment procedure is also discussed, which uses gingival incision followed by root planing. Healing after curettage involves blood clot formation, leukocyte proliferation, and re-epithelialization within 7 days.
This document discusses root canal preparation techniques presented by Dr. Fasahath Ahmed Butt. It covers the objectives of root canal preparations, which are to completely remove pulp tissue and bacteria while maintaining the original root canal anatomy. The main types of preparations discussed are crown-down, step-back, and hybrid techniques. For each technique, the document outlines the basic process and advantages and disadvantages. It also briefly covers different filing techniques used in root canal preparations like watch winding, reaming, and balanced force.
Periodontal Treatment Planning & Phase I TherapyRiad Mahmud
The document discusses periodontal treatment planning and phase I therapy. It begins by outlining the importance of establishing treatment goals, including immediate, intermediate, and long-term goals. The goals of treatment are to eliminate infection and inflammation, reduce pocket depth, and establish periodontal health to maintain oral function and health over the long term. Nonsurgical therapy generally begins with scaling and root planing to reduce infection, followed by reevaluation and possible surgical therapy if needed. The maintenance of oral hygiene is essential for long-term periodontal health.
This document discusses osseointegration, which refers to the direct structural and functional connection between bone and the surface of a load-bearing dental implant without intervening soft tissue. It traces the history and development of osseointegration from early experiments in the 1950s to its current understanding. The key aspects covered include definitions of osseointegration, the biological process of bone formation around implants over time, factors that influence osseointegration success, and future directions for improving integration.
socket shield technique is a modified method of implant placement where many short comings of implant placement can be solved...
it is nothing but retaining of buccal cortical plate during extraction and implant is placed immediatly
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
This document summarizes a surgical crown lengthening procedure performed on tooth 14. Crown lengthening involves surgically exposing more tooth structure to allow for proper placement of a restorative margin. For tooth 14, a full thickness flap was reflected and bone was removed to expose 1mm of tooth structure while maintaining the biological width. The flap was repositioned and sutured. Post-operative instructions included soft foods and chlorhexidine rinses. Follow up involved suture removal and irrigation.
This document provides an overview of root fractures, including their definition, classification, causes, diagnosis and management. It discusses the different types of root fractures - horizontal/transverse and vertical. For horizontal fractures, it describes their sub-classification based on location and extent. Diagnosis involves dental and medical history, clinical examination including mobility and radiographs. Management depends on the location of the fracture and includes repositioning and splinting, disinfection and obturation, or surgical removal of the apical fragment. Prognosis depends on maintaining the fragments in proper alignment during healing.
This document discusses various direct sequelae that can be caused by wearing removable dentures, including mucosal reactions, oral galvanic currents, altered taste perception, burning mouth syndrome, gagging, residual ridge reduction, periodontal disease of abutment teeth, and caries of abutment teeth. It focuses on denture stomatitis, providing classifications, causes, diagnostic methods, and management approaches. Predisposing factors, treatment with antifungals, and preventive measures are described. Other conditions addressed include flabby ridge, denture irritation hyperplasia, fibroepithelial polyp, traumatic ulcers, and burning mouth syndrome. Causes, diagnostic steps, and management of these conditions are
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
This document provides an overview of periodontal considerations for restorative dentistry. It discusses the normal periodontium, biologic width, and factors that can irritate the periodontium during restorative procedures. Margin placement is an important consideration, as subgingival margins pose the greatest biologic risk. Contour, contacts, embrasures and overhangs can also impact the periodontium. Proper evaluation and correction of biologic width violations is discussed to minimize risks to periodontal health from restorative work.
This document provides information about indirect retainers used in removable partial dentures (RPDs). It defines indirect retainers as parts of RPDs that function through lever action to help prevent displacement of distal extension bases. The main functions of indirect retainers are to shift the fulcrum line away from lifting forces and stabilize the denture. Factors like the effectiveness of direct retainers, distance from the fulcrum line, and rigidity of connectors impact the effectiveness of indirect retention. Common types of indirect retainers discussed include auxiliary occlusal rests, canine extensions, and continuous bar retainers.
This document provides an overview of furcation involvement and its management. It begins with definitions of terminology related to furcation anatomy. It then discusses classifications of furcation involvement, including Glickman's classification. Etiology is outlined, including factors like dental plaque, cervical enamel projections, root trunk length, and trauma from occlusion. Diagnosis involves probing, bone sounding, and radiographs. Treatment and prognosis are also mentioned. In summary, the document defines furcation involvement, classifies its severity, and discusses its causes, diagnosis, and management.
This document discusses resective osseous surgery for treating periodontal bone defects. It covers normal bone anatomy, classification of bone defects, rationale for resective surgery, techniques, instruments and steps. Resective surgery aims to reshape marginal bone to resemble healthy bone and facilitate maintenance. It can reliably reduce pocket depth by 0.6-1.2mm but risks root exposure and recession. Success requires careful patient selection and surgical skill.
Rene LeFort in 1901 classified midface fractures based on the level of injury into 3 types: Lefort I, II, and III fractures. Since then there have been modifications to the classification system. Lefort I fractures involve the maxilla above the teeth and nasal floor. Treatment involves either closed or open reduction with fixation methods like miniplates or wires. Potential complications include nerve damage, infection, malocclusion, and sinus issues. Contemporary approaches emphasize early open reduction and anatomical fixation with miniplates to achieve accurate reconstruction of the midface structural pillars.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Endodontics, also known as root canal treatment, treats the inside of teeth. It involves diagnosing, treating, and preventing diseases of the dental pulp and surrounding tissues. The key phases of root canal treatment are diagnosis to determine the treatment plan, cleaning and shaping the root canals, and obturation where the canals are filled with inert gutta percha and sealer to seal the canals. Root canal treatment aims to relieve pain and retain a tooth that may otherwise need extraction by removing the infected or inflamed pulp and disinfecting the root canal system.
FPD failures/dental CROWN & BRIDGE courses by Indian dental academyIndian dental academy
Bridge failures can occur due to various causes including cementation issues, mechanical failures of components, gingival/periodontal breakdown, caries, and pulp necrosis. Common causes of failure include faulty cement selection or application, inadequate tooth preparation, poor design, occlusal problems, and marginal discrepancies. Proper diagnosis, treatment planning, technique, and maintenance are required to achieve long-term success of fixed partial dentures.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides guidance on the examination, diagnosis, and treatment planning process for complete denture prosthodontics. It outlines the various components of patient history taking and clinical examination that are important to assess, including medical history, extraoral examination, intraoral soft tissue and residual ridge examination, radiographs, and mental attitude assessment. Factors such as age, gender, occupation, chief complaint, systemic diseases, neuromuscular function, saliva, arch size and shape, interarch relationship, and existing dentures are evaluated. The results of this process inform the treatment plan, which is discussed with the patient, and prognosis is determined.
The document discusses gingival curettage, which involves scraping diseased soft tissue from periodontal pockets. It describes different types of curettage including surgical, chemical, ultrasonic, and laser. Indications for curettage include shallow pockets and as maintenance treatment for recurrent inflammation. Contraindications include acute infections and pockets extending beyond the mucogingival junction. The procedure involves scraping the pocket wall with a curette. Excisional new attachment procedure is also discussed, which uses gingival incision followed by root planing. Healing after curettage involves blood clot formation, leukocyte proliferation, and re-epithelialization within 7 days.
This document discusses root canal preparation techniques presented by Dr. Fasahath Ahmed Butt. It covers the objectives of root canal preparations, which are to completely remove pulp tissue and bacteria while maintaining the original root canal anatomy. The main types of preparations discussed are crown-down, step-back, and hybrid techniques. For each technique, the document outlines the basic process and advantages and disadvantages. It also briefly covers different filing techniques used in root canal preparations like watch winding, reaming, and balanced force.
Periodontal Treatment Planning & Phase I TherapyRiad Mahmud
The document discusses periodontal treatment planning and phase I therapy. It begins by outlining the importance of establishing treatment goals, including immediate, intermediate, and long-term goals. The goals of treatment are to eliminate infection and inflammation, reduce pocket depth, and establish periodontal health to maintain oral function and health over the long term. Nonsurgical therapy generally begins with scaling and root planing to reduce infection, followed by reevaluation and possible surgical therapy if needed. The maintenance of oral hygiene is essential for long-term periodontal health.
This document discusses osseointegration, which refers to the direct structural and functional connection between bone and the surface of a load-bearing dental implant without intervening soft tissue. It traces the history and development of osseointegration from early experiments in the 1950s to its current understanding. The key aspects covered include definitions of osseointegration, the biological process of bone formation around implants over time, factors that influence osseointegration success, and future directions for improving integration.
socket shield technique is a modified method of implant placement where many short comings of implant placement can be solved...
it is nothing but retaining of buccal cortical plate during extraction and implant is placed immediatly
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
This document summarizes a surgical crown lengthening procedure performed on tooth 14. Crown lengthening involves surgically exposing more tooth structure to allow for proper placement of a restorative margin. For tooth 14, a full thickness flap was reflected and bone was removed to expose 1mm of tooth structure while maintaining the biological width. The flap was repositioned and sutured. Post-operative instructions included soft foods and chlorhexidine rinses. Follow up involved suture removal and irrigation.
This document provides an overview of root fractures, including their definition, classification, causes, diagnosis and management. It discusses the different types of root fractures - horizontal/transverse and vertical. For horizontal fractures, it describes their sub-classification based on location and extent. Diagnosis involves dental and medical history, clinical examination including mobility and radiographs. Management depends on the location of the fracture and includes repositioning and splinting, disinfection and obturation, or surgical removal of the apical fragment. Prognosis depends on maintaining the fragments in proper alignment during healing.
This document discusses various direct sequelae that can be caused by wearing removable dentures, including mucosal reactions, oral galvanic currents, altered taste perception, burning mouth syndrome, gagging, residual ridge reduction, periodontal disease of abutment teeth, and caries of abutment teeth. It focuses on denture stomatitis, providing classifications, causes, diagnostic methods, and management approaches. Predisposing factors, treatment with antifungals, and preventive measures are described. Other conditions addressed include flabby ridge, denture irritation hyperplasia, fibroepithelial polyp, traumatic ulcers, and burning mouth syndrome. Causes, diagnostic steps, and management of these conditions are
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
This document provides an overview of periodontal considerations for restorative dentistry. It discusses the normal periodontium, biologic width, and factors that can irritate the periodontium during restorative procedures. Margin placement is an important consideration, as subgingival margins pose the greatest biologic risk. Contour, contacts, embrasures and overhangs can also impact the periodontium. Proper evaluation and correction of biologic width violations is discussed to minimize risks to periodontal health from restorative work.
This document provides information about indirect retainers used in removable partial dentures (RPDs). It defines indirect retainers as parts of RPDs that function through lever action to help prevent displacement of distal extension bases. The main functions of indirect retainers are to shift the fulcrum line away from lifting forces and stabilize the denture. Factors like the effectiveness of direct retainers, distance from the fulcrum line, and rigidity of connectors impact the effectiveness of indirect retention. Common types of indirect retainers discussed include auxiliary occlusal rests, canine extensions, and continuous bar retainers.
This document provides an overview of furcation involvement and its management. It begins with definitions of terminology related to furcation anatomy. It then discusses classifications of furcation involvement, including Glickman's classification. Etiology is outlined, including factors like dental plaque, cervical enamel projections, root trunk length, and trauma from occlusion. Diagnosis involves probing, bone sounding, and radiographs. Treatment and prognosis are also mentioned. In summary, the document defines furcation involvement, classifies its severity, and discusses its causes, diagnosis, and management.
This document discusses resective osseous surgery for treating periodontal bone defects. It covers normal bone anatomy, classification of bone defects, rationale for resective surgery, techniques, instruments and steps. Resective surgery aims to reshape marginal bone to resemble healthy bone and facilitate maintenance. It can reliably reduce pocket depth by 0.6-1.2mm but risks root exposure and recession. Success requires careful patient selection and surgical skill.
Rene LeFort in 1901 classified midface fractures based on the level of injury into 3 types: Lefort I, II, and III fractures. Since then there have been modifications to the classification system. Lefort I fractures involve the maxilla above the teeth and nasal floor. Treatment involves either closed or open reduction with fixation methods like miniplates or wires. Potential complications include nerve damage, infection, malocclusion, and sinus issues. Contemporary approaches emphasize early open reduction and anatomical fixation with miniplates to achieve accurate reconstruction of the midface structural pillars.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Endodontics, also known as root canal treatment, treats the inside of teeth. It involves diagnosing, treating, and preventing diseases of the dental pulp and surrounding tissues. The key phases of root canal treatment are diagnosis to determine the treatment plan, cleaning and shaping the root canals, and obturation where the canals are filled with inert gutta percha and sealer to seal the canals. Root canal treatment aims to relieve pain and retain a tooth that may otherwise need extraction by removing the infected or inflamed pulp and disinfecting the root canal system.
FPD failures/dental CROWN & BRIDGE courses by Indian dental academyIndian dental academy
Bridge failures can occur due to various causes including cementation issues, mechanical failures of components, gingival/periodontal breakdown, caries, and pulp necrosis. Common causes of failure include faulty cement selection or application, inadequate tooth preparation, poor design, occlusal problems, and marginal discrepancies. Proper diagnosis, treatment planning, technique, and maintenance are required to achieve long-term success of fixed partial dentures.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses various types of failures that can occur in fixed partial dentures (FPDs). It classifies failures as either biologic, mechanical, or aesthetic. Biologic failures include issues like caries, pulpal degeneration, endodontic failure, periodontal failure, tooth perforations, sub-pontic inflammation, and occlusal problems. Mechanical failures involve loss of retention, connector failure, occlusal wear, and tooth fracture. Aesthetic failures can be immediate due to issues in design, materials or workmanship, or delayed due to gingival recession or sub-pontic tissue shrinkage over time. The document provides details on causes and treatments for each type of failure.
Veneers provide a minimally invasive treatment option to change tooth shape, position, color and surface appearance. They can withstand occlusal forces extremely well when made of materials like Dicor or Empress. However, careful case selection and proper preparation, fabrication, cementation and follow up are required to achieve optimal esthetic results and avoid disadvantages like fractures or poor marginal integrity. Newer ceramic materials and techniques have improved the longevity and outcomes of veneer treatments.
This document discusses considerations for removable partial denture (RPD) bases. It describes the functions of denture bases in supporting artificial teeth and transferring forces. Tooth-supported bases span between abutments and prevent migration with rests. Distal extension bases aim to minimize movement and improve stability. Maximum support is achieved through anatomic knowledge and impression/base accuracy. Materials like acrylic and thermoplastics are discussed. Relining may be needed due to tissue changes. Anterior and posterior tooth replacements can use acrylic, composite, porcelain or metal options. Stress breakers help minimize forces on tissues. Relining re-establishes ridge support for distal extension bases due to ridge changes over time.
This document provides information on onlay restorations, including definitions, types, advantages, disadvantages, and preparation methods. It discusses cast metal onlays and esthetic onlay restorations. Preparation involves capping all cusps and includes details on marginal locations. Advantages are cuspal protection and being more conservative than a crown. Disadvantages include greater occlusal reduction and need for parallel walls. Fabrication involves impression taking and producing the restoration using various techniques like firing, pressing, or CAD/CAM milling.
This document discusses the various causes and management of failures in fixed partial dentures (FPDs). It identifies biological, mechanical, esthetic, and facing failures and describes common reasons for each. Biological failures include caries, pulp degeneration, periodontal breakdown, occlusal problems, and tooth perforation. Mechanical failures involve loss of retention, connector failure, occlusal wear, tooth fracture, and porcelain fracture. Management strategies focus on identifying and addressing the underlying cause, which may involve repairs, remakes, or extractions. The goal is to effectively solve failures while preserving teeth and restorations where possible.
1. Fixed prosthodontic devices (FPDs) can fail due to issues with retention, mechanical components, abutment teeth, design, technique, occlusion, or supporting structures.
2. Common causes of FPD failure include loss of retention, porcelain fracture, periodontal disease, caries, excessive occlusal wear, and pulp necrosis. Inadequate design, technique errors, and occlusal problems can also lead to failure.
3. Thin cement mixes, improper isolation, excess cement, and incomplete removal of temporary cement are some causes of cementation failure, while short clinical crowns and excessive taper can reduce retention of FPDs.
This document discusses laminate veneers, including:
1. Laminate veneers have evolved over decades to become a popular aesthetic restoration, providing a conservative alternative to full coverage restorations.
2. They involve bonding thin ceramic restorations to etched tooth structure to restore the facial and proximal surfaces.
3. Indications include masking diastemas, discoloration, enamel defects, malpositioned teeth, while contraindications include insufficient tooth structure or parafunctional habits.
principles of tooth preparation - ann george final.pptxHimanshu Tiwari
This document discusses principles of tooth preparation for dental restorations. It covers 3 main topics:
1. Biological principles including conservation of tooth structure, preventing damage to adjacent teeth and soft tissues, and the pulp.
2. Mechanical principles such as retention form, resistance form, and structural durability.
3. Aesthetic principles regarding metal-ceramic and partial coverage restorations.
It also describes different margin designs including chamfer, shoulder, knife edge, and their indications. Maintaining margin integrity through proper placement, geometry and adaptation is emphasized.
principles of tooth preparation - ann george final.pptxDrHIMANSHUTIWARI1
No recent literature has reviewed the current scientific knowledge on complete coverage tooth preparations.Nine scientific principles have been developed that ensure mechanical, biologic, and esthetic success for tooth preparation of complete coverage restorations.
explained with Limited matter moreover I have included all the images. if you go through a standard textbook and referred to this PPT it will help you so much I hope It helps you. ask me for the books details.
The document discusses various types of full coverage restorations for primary anterior teeth including stainless steel crowns with composite facings, composite strip crowns, polycarbonate crowns, New Millennium crowns, Kudos crowns, Pedo jacket crowns, and Artglass crowns. It describes the materials, advantages, disadvantages, and placement techniques for each type of crown. Stainless steel crowns with composite facings combine strength, durability and improved aesthetics but take longer to place. Composite strip crowns provide good aesthetics but are technique sensitive. Polycarbonate crowns and Kudos crowns are more durable alternatives that are easier to place than composite strip crowns.
The document discusses resin bonded fixed partial dentures (RBFPDs), also known as adhesive bridges. It covers the history, definitions, classifications, indications, contraindications, and various types of RBFPDs including bonded pontics, cast perforated resin-retained FPDs, etched cast resin-retained FPDs, and macro-mechanical retention resin-retained FPDs. Preparation designs for anterior and posterior teeth are described. Bonding involves cleaning, etching, priming, and using composite resin cements.
Class i, ii indirect tooth coloured restoration smidsendo
Indirect tooth-colored restorations like composite resin inlays and ceramic inlays provide improved esthetics and physical properties compared to direct restorations. They require greater technique sensitivity due to the additional lab steps. Indirect restorations are best for large class I and II defects, and situations requiring improved contacts and contours. Contraindications include areas of heavy occlusal forces, inability to maintain a dry field, and deep subgingival preparations. Advantages include esthetics, strength, contour, and reduced microleakage. Disadvantages are increased cost and time. Fabrication involves tooth preparation, impression taking, lab processing, try-in, cementation, and finishing/polishing.
This document discusses resin bonded fixed partial dentures (FPDs). It begins by defining resin bonded FPDs and describing their history. It then covers indications and contraindications, advantages and disadvantages, classifications based on retention type, and fabrication process including tooth preparation, impressions, provisionals, and bonding. Resin bonded FPDs are adhesive bridges that replace missing teeth using thin metal retainers bonded to abutment teeth with resin cement. They conserve tooth structure and have advantages over traditional FPDs like reduced cost and chairtime.
This document discusses complex amalgam restorations that involve replacing one or more missing cusps using techniques like pin retention. It describes different types of complex amalgam restorations like pin-retained, slot-retained, and amalgam foundations. It also discusses the different types of pins used like cemented pins, friction-locked pins, and self-threading pins. The key factors affecting pin retention are the pin diameter, number of pins used, and pin type.
Similar to Fpd failures/certified fixed orthodontic courses by Indian dental academy (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
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at the appropriate level.(Within 2 yrs of application date )
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1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Dental tissues and their replacements/ oral surgery courses
Fpd failures/certified fixed orthodontic courses by Indian dental academy
1. Bridge Failures
“Technology in the hands of a skilled operator makes it possible
to do more work of an even higher quality. But in the hands of one
who has not mastered the skills of his or her profession, that
technology merely enables one to do tremendous damage.”
-
Herbert T. Shillingburg
Excellence in dental care is achieved through the dentist’s ability to
assess the patient, determine needs, design an appropriate treatment
plan and execute the plan with proficiency.
CLASSIFICATIONS
The causes of FPD failures were summarized as early as in 1920 when Tinker
wrote
“Chief among the causes for such disappointing results has been:
First: Faulty, and in some cases, no attempt at diagnosis and prognosis.
Second: Failure to remove foci of infection in attention to treatment and care of the
investing tissues and mouth sanitation.
Third: Disregard for tooth form
Fourth: Absence of proper embrasures
Fifth: Inter proximal spaces
Sixth: Faulty occlusion and articulation
2. Other classification given by Bennard G. N. Smith
1. Loss of retention
2. Mechanical failure of crowns or bridge components
a. Porcelain fracture
b. Failure of solder joints
c. Distortion
d. Occlusal wear and perforation
e. Lost facings
3. Changes in the abutment tooth
a. Periodontal disease
b. Problems with the pulp
c. Caries
d. Fracture of the prepared natural crown or root
e. Movement of the tooth
4. Design failures
a. Under-prescribed FPDs
b. Over-prescribed FPDs
5. Inadequate clinical or laboratory technique
a. Positive ledge
b. Negative ledge
c. Defect
d. Poor shape and color
6. Occlusal problems
3. Failures of FPD
Failures of fixed partial dentures occur based on:
• Patient complaints
• Duration of time
Patient complaints
• Pain
• Sensitivity
• Looseness of bridge
• Pain in soft tissue (gingiva)
• Esthetics
• Fracture
• Swelling
• Speech
• Mastication
Duration of time
• Immediate
• Delayed
TYPES OF BRIDGE FAILURES
I.
Cementation failure
II.
Mechanical failure
III.
Gingival and periodontal breakdown
IV.
Caries
V.
Necrosis of pulp
VI.
Esthetic failure
4. I.CEMENTATION FAILURE
• Cement failure
• Retention failure
• Occlusal problems
• Distortion of the bridge
Cement Failure
• Cement selection
• Old cement
• Prolonged mixing time
• Thin mix
• Thick mix
• Cement setting prior to seating
• Inadequate isolation
• Incomplete removal of temporary cement
• Thick cement space
• Inclusion of cotton fibers
• Insufficient pressure while cementation
5. Cement Selection
• FPD Multiretainers - GIC
• Non Vital Teeth/Advanced Pulp Recession - ZINC PHOSPHATE
• Temporary Cementation - ZINC OXIDE EUGENOL
• Fixation of Facings- DIMETHACRYLATE COMPOSITES
• Abutment with Minimal Dentin / Exposure - CALCIUM HYDRO
OXIDE + ZINC OXIDE EUGENOL
Thick Cement Space
• Convergence below 6º
• Excessive application of die spacer
• Thick cement mix
• Grinding metal inside retainers
• Cement setting prior to seating
How to Confirm Cement Failure
Pull the crown margin and see for movement of the crown
Crown margins which were subgingivally placed will be visible
when we pull the crown margin
6. Bubbles come out of the margin or through perforation of the crown
(if present) when the crown margin is pushed by applying pressure
occlusally
Retention failure
• Excessive taper
• Short clinical crown
• Mis-fit
• Mis-alignment
Retention
• Retention prevents the removal of the restoration along the path of
insertion or the long axis of the tooth.
• Resistance prevents dislodgement of the restoration by forces
directed in apical or oblique direction
Improving Retention
• Additional retentive grooves/ proximal grooves.
• Additional pins- drill the retainer & tooth .5 to .7 mm with round
bur in buccal & lingual aspects, cut the excessive length & smoothen
7. the area.
• Crown lengthening
• Sub gingival margins
• Additional abutments
Excessive Taper
• The relationship of one wall of preparation to the long axis of that
preparation is the inclination of that wall.
• Sum of the inclination of two opposing walls give the taper of the
preparation.
• Minimum 12º taper is necessary to ensure the absence of undercuts
& also the restoration is placed on the preparation after being
fabricated in final form.
• Conscious effort to incorporate taper usually results in over tapered,
non retentive preparation.
Short Clinical Crown
• Cement creates a weak bond, largely by mechanical interlocks,
between the inner surface of the restoration & the axial wall of the
preparation. So, greater the surface area of preparation, greater wills
8. the retention.
• A short, over tapered crown would have minimal ret ention because
the restoration can be removed along infinite paths.
• Because the length of axial wall occlusal to finish line interferes
with the displacement, the length & inclination become important
factors.
Misfit
Causes
• Expansion of metal substructure because of
-Improper water /powder ratio of investment
-Improper mixing time
-Improper burn out temperature
• Distortion of the margins
• Distortion of metal substructure
• Metal bubbles in occlusal or margin regions because of
- Inadequate vacuum during investing
- Improper brush technique
-
No surfactant
• Porcelain inside retainer
9. • Excessive oxide layer in inner side of retainer
• Tight contact points
• Thick cement space
• Insufficient pressure during cementation
Misalignment
• In case of misalignment the bridge will +ve spring in it & tend to
seat further on pressure due to abutment teeth moving slightly
• In misfit the resistance felt is solid.
Causes
• Abutment displacement due to improper temporization.
• Distortion of wax pattern
• Casting defects
• Distortion of metal framework in porcelain firing.
• Porcelain flow inside the retainers
• Mal alignment of solder joints
• Excessive metal or porcelain in tissue surface of pontic.
Remedy
• If the bridge seats fully under pressure - leave it in place for 30 min
to 1 hr asking the patient to exert gentle pressure.
10. • If it does not work, temporarily cement to one of the retainers for 1
to 2 days.
• Then, the bridge is unsoldered, separate components tried. If they
seat, take location impression & resolder.
Occlusal problems
Problems in occlusion are basically
Immediate problems
1. Occlusal interferences
2. Marginal ridges at different levels
3. Supra eruption of opposing tooth
4. Para functional habits
Delayed problems
1. Wearing of occlusal surfaces
2. Loss of occlusal contacts
3. Cementation failure due to lateral forces
4. Periodontal and gingival breakdown
5. Tenderness
Torque
• From a cusp extended too far bucally or lingually.
• Pre mature contact on lateral excursion extremity.
11. • Results in cementation failure.
Reduce bucco lingual width of occlusal surface
Indications
• Mobility of teeth
• Tenderness on mastication
• Hyperemia of soft tissues
• Sensitivity to heat, cold & sweet
• Burnished metal in area of premature contact
Checking occlusion
Touch
Tin articulating paper
Occlusal indicator wax
Occlusion should be adjusted both in centric and eccentric
Distortion
• Distortion of wax patterns
• Incomplete casting
12. • Long span bridges
Wax Patterns
• Removal from the die
• Spruing stage
• Investing stage because of the thick investment material.
Incomplete Casting
• Too thin wax patterns
• Incomplete wax elimination
• Cool mold or melt
• Insufficient metal
Long Span Bridges
• Thin crown
• Soft metal
• Heat treatment not being done
• Porosity in the metal
• Distortion of margins.
13. MECHANICAL FAILURE
1. Retainer failure
2. Pontic failure
3. Connector failure
Retainer Failure
Perforation
• Insufficient occlusal reduction
• High points in opposing dentition
• Premature contacts
• Soft metal
• Porosity
• Para functional habits
Marginal Discrepancy
The more accurately the restoration is adapted to tooth, the less
will be chances of cementation failure, recurrent caries or periodontal
disease. 50μ to 100μ discrepancy is acceptable.
• Rough margins reduce adaptation
• Open margins encourage entry of saliva and cariogenic organisms
• Over extended margins cannot be adapted to converging convexity
of tooth at cervical margin
14. Causes
• Selection of margin
• Improper preparation
• No gingival retraction
• Improper selection of impression materi al
• Distortion of wax patterns
• Nodules at margin or inside casting
• Thick cement
• Prior setting of cement
Facing Failure
Fracture
Too little retention
Spot contact at porcelain metal junction
Malocclusion
Microleakage.
Wearing
15. • Deep bite
• Acrylic veneering opposing porcelain teeth
• Faulty brushing & flossing
• Parafunctional habits
Discoloration
• Absorption of oral fluids
• Absorption
of
artificial
food
colouring
agents
through
the
microcracks or microleakage in metal & facing
• Tarnish of underlying metal & facing
Pontic failure
Requirements
F o r m & s h a p e o f g i n g i v al s u r f a c e mu s t n o t i r r i t a t e r e s i d u a l r i d g e
Design must incorporate mechanical principles for strength &
longevity
Esthetics
Residual Ridge Contour
• Ideal - smooth, easy to clean
• Irregular hyperplastic tissue (commonly because of an ill fitting rpd)
16. must be surgically removed
• Severe bone resorption (particularly because of trauma) - surgical
ridge augmentation
Ridge Contact
• Pressure free contact without blanching.
• In esthetic zone, the pontic should contact on the labial/ buccal
aspect.
• In mandibular posteriors hygienic pontic can be given.
Metal Sub Structure is compromised due to
• Limited edentulous space in Occluso gingival direction due to supra
eruption of opposing tooth.
• Limited space mesiodistally due to drifting of adjacent teeth
• Framework must provide uniform thickness for porcelain - cut back
wax uniformly
Metal ceramic junction should be 1.5 mm away fr om junction.
GINGIVAL AND PERIODONTAL BREAKDOWN
- Margins placement
- Integrity of contacts and margins
- Occlusion
17. Reasons for gingival breakdown
•
•
•
•
•
•
Plaque retention
Improper design
Faulty margins
Incorrect occlusal anatomy
Over contoured retainer
Inadequate embrasure
Treatment options:
• Give proper oral hygiene instructions
• Remake the bridge
Reasons for periodontal breakdown:
• General periodontal problems
• Local periodontal problems like
- Poor bridge design
- Incorrect assessment of abutment strength
- Insufficient abutment selected
- Traumatic occlusion
Treatment options:
• Remake the bridge
Supra Gingival Margins
Advantages
• Can be easily finished
• Easily cleanable
• Impressions easily recordable
• Easy evaluation at recall
18. Disadvantages
• Esthetically inferior
• Not indicated for short clinical crowns
• Not indicated in case of root sensitivity
Sub Gingival Margins
Indications
• Esthetic demands
• Caries removal
• Existing sub gingival restorations
• Crown lengthening.
Disadvantages
• Difficult to prepare
• Soft tissue prone to trauma
• Causes gingival & periodontal pathosis
• Difficult oral hygiene
• Metal margins seen through gingival.
19. CARIES
• Caries occouring on the margin of the retainer,
• Caries affecting indirectly by starting elsewhere on the tooth and
spreading.
• Caries due to cementation failure.
Reasons for caries:
• Poor oral hygiene
• Open margins
• Faulty contacts
Treatment options:
• Use conventional filling materials
• Correction of crowns and bridges if possible
• Remake the bridge
NECROSIS OF PULP
Can occour at three stages
- Prior to preparation
- During preparation
- After preparation
20. Reasons for pulp necrosis:
• Increased occlusal trauma
• Increased heat during preparation
• No pulp protection
Other reasons for pulp necrosis:
• Speed, size, and type of the rotating instrument
• The amount of pressure used
• Depth of remaining dentin
• Vibration
• Coolants
• Desiccation
• Chemical injury
Treat ment options:
• For anterior teeth – apicecto my and retrograde filling
• For posterior teeth – endodontic therapy
• R e ma k e t h e b r i d g e
ESTHETIC FAILURES
Requirements for Esthetic Restorations
Proper shade selection
Correct tooth preparation
Avoidance of grey margins
Prevention of metal exposure
Final impression
21. Reasons for Esthetic Failure
• Failure to identify patient expectations regarding esthetics
• Improper shade selection
• Failure to transfer shade selection to laboratory
• Excessive metal thickness at incisal and ce rvical regions
• Over glaze or too much smooth surface
• Metal exposure in connector, cervical, and incisal region
• Dark space in cervical third due to improper pontic selection
(anteriors)
• Failed to produce incisal and proximal translucency
• Improper contouring
• Failure to harmonize contra-lateral tooth morphology- contour,
colour, position, angulations
• Discoloration of facing
Shade Selection
• Walls and surroundings should be in neutral colour or blue
• Never select under direct sunlight
• Upright position of the patient
• Use squint test
• Teeth should be clean and unstained
22. • Shade selection should be done before teeth preparation
• Don’t dry the tooth while selecting the shade
• Canine is the darkest tooth
• Premolars lighter shade than canine
• Maxillary anteriors are missing, shade of the mandibular anteriors is
considered
• In case of a non-vital tooth, cover it and select the shade of the
adjacent tooth.
Other Biologic bridge failure are
Fracture of tooth
Reasons for fracture:
• Improper abutment selection
• Wear of tooth
• Increased occlusal forces
Treatment options:
• Remake the bridge using more abutment teeth.
Temporo-mandibular joint problems
23. R e a s o n s f o r TM J p r o b l e ms :
• I mp r o p e r o c c l u s a l s c h e me
Treat ment options:
• R e ma k e t h e b r i d g e u s i n g p r o p e r o c c lu s a l s c h e me
Caries… the frequent culprit
Caries – 38%
Periapical involvement – 15%
Perforated occlusal surface – 10%
Fracture post &core – 8%
Defective margins – 8%
Fracture teeth – 7%
Porcelian failures – 8%
JPD, Vol 78, Issue 2, pg 127-131, Aug 1997
24. Conclusion
Failures most often occur because of violation of principles either
collectively or individually and for the most part are due to attempted
short-cuts or positive indifference and inexcusable ignorance on the
part of those concerned. Whatever said and done, at last it is only the
ability of a Prosthodontist which determines the success or failure of a
fixed partial denture.
25. Bibliography
• Shillingburg HT, Hobo S, Whitsett LD, Jacobe R, and Brackett SE:
Fundamentals of fixed prosthodontics, ed. 3, Chicago, 2001, Quintessence,
Inc.
• Tylman’s theory and practice of fixed Prosthodontics,8th edi,1989,William
F.P.Malone, David .L.Koth
• Roberts DH: Fixed bridge prosthesis, ed. 1, Bristol, 1973, John Wright &
Sons.
• Rosenstiel SF, Land MF and Fujimoto J: Contemporary fixed
prosthodontics, 2001, ed. 3, N.Delhi, Harcourt.
• Longevity of fixed partial dentures,JPD,Vol 78,Issue 2,Pg 127-131,Aug
1997.
• Failures related to crown and fixed partial dentures fabricated in Nigerian
dental school, Journal of contemporary dental practise, Vol 6, No 4,Nov
15,2005.
• Clinical complications in fixed Prosthodontics, JPD,2003,90 Vol, pg 31-41
26. A seminar on
Failures in fpd
Presented by
Dr.G.MANMOHAN,
Final year P.G Student,
Date: 12-07-08.
Signature of Prof & HOD
SIBAR INSTITUTE OF DENTAL SCIENCES
Guntur-522509