Introduction to fixed partial dentures/ online orthodontic courses

Introduction to Fixed Partial Dentures.Introduction to Fixed Partial Dentures.
 A Fixed Partial denture may be defined as “A Fixed Partial denture may be defined as “AA
partial denture that is cemented to naturalpartial denture that is cemented to natural
teeth or roots which furnish the primaryteeth or roots which furnish the primary
support to the prosthesis”.support to the prosthesis”.
 Fixed prosthesis may be defined asFixed prosthesis may be defined as, “ A, “ A
restoration or replacement to which isrestoration or replacement to which is
attached by a cementing medium to naturalattached by a cementing medium to natural
teeth, roots, implants”.teeth, roots, implants”.
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Common Terms used in FPDCommon Terms used in FPD
 CROWN :CROWN :
 Cemented extracoronal restoration that covers or veneersCemented extracoronal restoration that covers or veneers
the outer surface of the clinical crown.the outer surface of the clinical crown.
 Primary function of a crown is to protect the underlyingPrimary function of a crown is to protect the underlying
tooth structure and restore the function, form andtooth structure and restore the function, form and
aesthetics.aesthetics.
 Crowns may be of three types:Crowns may be of three types:
 ““Clinical crown”Clinical crown” depicts the intra orally visible toothdepicts the intra orally visible tooth
structure.structure.
 ““Anatomical crownAnatomical crown” depicts the area of the tooth covered” depicts the area of the tooth covered
by the enamel.by the enamel.
 ““Artificial crownArtificial crown” depicts the area of the tooth replaced by” depicts the area of the tooth replaced by
the clinician.the clinician.

 If the prosthetic crownIf the prosthetic crown
covers all the fivecovers all the five
surfaces it is referred tosurfaces it is referred to
as full veneered crown.as full veneered crown.
If it does not cover theIf it does not cover the
entire tooth surface thenentire tooth surface then
it is partial veneerit is partial veneer
crown.crown.

Metal ceramic and all metalMetal ceramic and all metal

Laminate Veneers.Laminate Veneers.
 Prosthesis made ofProsthesis made of
ceramicceramic material whichmaterial which
usually covers the facialusually covers the facial
surface of the tooth,surface of the tooth,
primarily for aestheticprimarily for aesthetic
purposes.purposes.

InlaysInlays
 It is anIt is an intracoronalintracoronal
restorationrestoration, used for, used for
medium sized singlemedium sized single
tooth, proximo-occlusaltooth, proximo-occlusal
and gingival lesions.and gingival lesions.

OnlayOnlay
 It is anIt is an ExtracoronalExtracoronal
restorationrestoration which iswhich is
used to restore a moreused to restore a more
extensively damagedextensively damaged
tooth with a widetooth with a wide
mesio-occluso-distalmesio-occluso-distal
lesion.lesion.

AbutmentAbutment
 Any tooth, root orAny tooth, root or
implant which, givesimplant which, gives
attachment and supportattachment and support
to the fixed partialto the fixed partial
denture.denture.
 Pier abutmentPier abutment

Indications for FPDIndications for FPD
 Short span edentulous arches.Short span edentulous arches.
 Presence of sound teeth that can offerPresence of sound teeth that can offer
sufficient support adjacent to the edentuloussufficient support adjacent to the edentulous
spaces.spaces.
 Cases with ridge resorption where a removableCases with ridge resorption where a removable
partial denture cannot be stable or retentive.partial denture cannot be stable or retentive.
 Patient’s preference.Patient’s preference.

Contra-indications.Contra-indications.
 Large amount of bone loss as in trauma.Large amount of bone loss as in trauma.
 Very young patients where the teeth have largeVery young patients where the teeth have large
pulp chambers.pulp chambers.
 Presence of periodontal compromisedPresence of periodontal compromised
abutments.abutments.
 Long span edentulous spaces.Long span edentulous spaces.
 Bilateral edentulous spaces which requireBilateral edentulous spaces which require
cross arch stabilisation.cross arch stabilisation.

Contd ……Contd ……
 Congenitally malformed teeth, which do notCongenitally malformed teeth, which do not
have adequate under lying tooth structure tohave adequate under lying tooth structure to
support.support.
 Very old patients as they may not be able toVery old patients as they may not be able to
follow oral hygiene instructions.follow oral hygiene instructions.

Parts of an FPDParts of an FPD
 Retainers :Retainers :
May be defined as theMay be defined as the
part of a fixed partialpart of a fixed partial
denture, which unitesdenture, which unites
the abutment(s) to thethe abutment(s) to the
remainder of theremainder of the
restoration.restoration.

Types of Retainers.Types of Retainers.
 Based on the tooth coverage.Based on the tooth coverage.
Major retainersMajor retainers ::
a. Full veneer crowns.a. Full veneer crowns.
b. Partial veneer crowns.b. Partial veneer crowns.
Minor retainers :Minor retainers :
a. Inlays.a. Inlays.
b. Onlays.b. Onlays.

Based on materials being used.Based on materials being used.
 All metal retainers.All metal retainers.
 Metal ceramic retainers.Metal ceramic retainers.
 All ceramic retainers.All ceramic retainers.
 Porcelain fused to metal retainers.Porcelain fused to metal retainers.
 Acrylic fused to metal retainers.Acrylic fused to metal retainers.

Full veneer crowns.Full veneer crowns.
 Covers all the fiveCovers all the five
surfaces of thesurfaces of the
abutment. They areabutment. They are
fabricated like a cap andfabricated like a cap and
are usually indicated forare usually indicated for
extensively damagedextensively damaged
teeth.teeth.
 Most retentive and idealMost retentive and ideal
retainers because theirretainers because their
design can resistdesign can resist
masticatory forces in allmasticatory forces in all
the directions.the directions.

Partial veneer crowns.Partial veneer crowns.
 Require less toothRequire less tooth
reduction.reduction.
 Less retentive comparedLess retentive compared
to full veneer crowns.to full veneer crowns.
 Depending on theDepending on the
number of surfacesnumber of surfaces
prepared they can beprepared they can be
classified as follows --classified as follows --
..

Three quarter crownThree quarter crown
(3/4th(3/4th))
Here three surfaces areHere three surfaces are
prepared to receiveprepared to receive
retainer usuallyretainer usually
maxillary canines,maxillary canines,
premolars receive suchpremolars receive such
a type of retainera type of retainer

Contd …..Contd …..
 7/87/8thth
crowncrown::
Here the whole tooth isHere the whole tooth is
divided into 8 surfacesdivided into 8 surfaces
of which seven isof which seven is
prepared to receiveprepared to receive
retainer usuallyretainer usually
Maxillary first molar isMaxillary first molar is
prepared for such aprepared for such a
retainer.retainer.

Conservative retainers.Conservative retainers.
 They cannot accept heavy occlusal loads andThey cannot accept heavy occlusal loads and
are primarily indicated for anterior teeth.are primarily indicated for anterior teeth.
 Require minimal tooth preparation.Require minimal tooth preparation.
 Some of them may have small metalSome of them may have small metal
extensions, which are designed to be lutedextensions, which are designed to be luted
directly on to the lingual surface of thedirectly on to the lingual surface of the
abutment teeth using a resin cement.abutment teeth using a resin cement.
Ex-Ex- Maryland bridgesMaryland bridges..

Maryland bridgeMaryland bridge

All metal retainersAll metal retainers
 They can be partial or full veneer crowns.They can be partial or full veneer crowns.
 Require minimal tooth reduction.Require minimal tooth reduction.
 Strong even in thin sections.Strong even in thin sections.

Metal ceramic retainers.Metal ceramic retainers.
 May be fabricated asMay be fabricated as
entire full veneerentire full veneer
crowns.crowns.
facings over the labial/facings over the labial/
buccal surface of thebuccal surface of the
full veneer crowns.full veneer crowns.
 Relatively more amountRelatively more amount
of tooth is reduced here.of tooth is reduced here.

All ceramic retainers.All ceramic retainers.
partial veneer or fullpartial veneer or full
veneer crowns.veneer crowns.
 Require maximum toothRequire maximum tooth
reduction as porcelainreduction as porcelain
requires bulk forrequires bulk for
adequate strength.adequate strength.

Acrylic retainers.Acrylic retainers.
 Used as long termUsed as long term
temporary fixed partialtemporary fixed partial
dentures.dentures.
 They are not indicatedThey are not indicated
for permanentfor permanent
restorations.restorations.

PonticsPontics
 May be defined as,May be defined as,
““An artificial tooth onAn artificial tooth on
a fixed partial denturea fixed partial denture
that replaces a missingthat replaces a missing
tooth, restores itstooth, restores its
functions and usuallyfunctions and usually
fills the spacefills the space
previously filled by apreviously filled by a
natural crownnatural crown”.”.

Ideal requirements of a pontic.Ideal requirements of a pontic.
 To restore the function of the tooth which itTo restore the function of the tooth which it
replaces.replaces.
 Should provide good aesthetics.Should provide good aesthetics.
 Should be bio-compatible, should not impingeShould be bio-compatible, should not impinge
on the tissues and should not cause anyon the tissues and should not cause any
allergic reaction.allergic reaction.
 Should permit effective oral hygeine.Should permit effective oral hygeine.

Contd ……Contd ……
 Preserve underlying mucosa and bone.Preserve underlying mucosa and bone.
 Comfortable for the patient.Comfortable for the patient.
 Economical.Economical.

Factors affecting the design of aFactors affecting the design of a
pontic.pontic.
 Space available for theSpace available for the
placement of a pontic.placement of a pontic.
 The contour of theThe contour of the
residual alveolar ridge.residual alveolar ridge.
 Amount of occlusal loadAmount of occlusal load
that is anticipated forthat is anticipated for
that patient.that patient.

Surfaces of a pontic.Surfaces of a pontic.
 Gingival surface.Gingival surface.
 The material used and the degree of tissueThe material used and the degree of tissue
contact affect the success of restoration.contact affect the success of restoration.
 Highly glazed porcelain is the material ofHighly glazed porcelain is the material of
choice. Equally important is the finish of thechoice. Equally important is the finish of the
material.material.
 Pontic should never pressurize the alveolarPontic should never pressurize the alveolar
mucosa, tissue contact should be minimal.mucosa, tissue contact should be minimal.

Occlusal surface.Occlusal surface.
 Size of the occlusal table to be reduced toSize of the occlusal table to be reduced to
decrease the load on the abutment.decrease the load on the abutment.
 The functional cusp should not be reduced toThe functional cusp should not be reduced to
preserve a stable vertical dimension. Thepreserve a stable vertical dimension. The
functional cusp is the load bearing cusp of thefunctional cusp is the load bearing cusp of the
tooth.tooth.
 In the maxillary teeth buccal cusps provideIn the maxillary teeth buccal cusps provide
aesthetics. In the lower teeth lingual cusps aidaesthetics. In the lower teeth lingual cusps aid
to protect tongue.to protect tongue.

Proximal surfaces.Proximal surfaces.
 Vertical clearance should be adequate toVertical clearance should be adequate to
permit physiologic contour of the pontic andpermit physiologic contour of the pontic and
allow space for the inter proximal tissues.allow space for the inter proximal tissues.
 Interproximal embrasures should be left openInterproximal embrasures should be left open
to permit easy cleansing.to permit easy cleansing.
 Sizes of the maxillary inter-proximal spacesSizes of the maxillary inter-proximal spaces
should be reduced for the sake of aesthetics.should be reduced for the sake of aesthetics.
 Sufficient space should be given to avoidSufficient space should be given to avoid
impingement to the inter-dental papilla.impingement to the inter-dental papilla.

Buccal and lingual surfaces.Buccal and lingual surfaces.
 Facial surfaces should be designed withFacial surfaces should be designed with
aesthetics as the primary concern ,it shouldaesthetics as the primary concern ,it should
resemble the adjacent teeth.resemble the adjacent teeth.
 Lingual surfaces should be designed asLingual surfaces should be designed as
hygeine as primary concern.hygeine as primary concern.

Posterior pontics.Posterior pontics.
 All surfaces should be convex, smooth andAll surfaces should be convex, smooth and
well finished.well finished.
 Contact with the ridge should be minimal andContact with the ridge should be minimal and
passive.passive.
 Occlusal table should be in harmony withOcclusal table should be in harmony with
other teeth in the arch.other teeth in the arch.
 Buccal and lingual embrasures shouldBuccal and lingual embrasures should
correspond to the other natural teeth.correspond to the other natural teeth.

Connectors.Connectors.
 May be defined as, “May be defined as, “ AA
portion of a fixedportion of a fixed
partial denture thatpartial denture that
unites the retainers andunites the retainers and
pontics”.pontics”.
 Broadly classified into –Broadly classified into –
Rigid connectors.Rigid connectors.
Non rigid connectors.Non rigid connectors.

Rigid connectors.Rigid connectors.
 Used to unite retainers and pontics in a fixed-Used to unite retainers and pontics in a fixed-
fixed partial denture.fixed partial denture.
 Transmits entire occlusal load to the abutment.Transmits entire occlusal load to the abutment.
 Fabricated by casting a part of multi-unit waxFabricated by casting a part of multi-unit wax
pattern or by soldering.pattern or by soldering.
 Design of rigid connectors is incorporated inDesign of rigid connectors is incorporated in
the wax pattern.the wax pattern.

Non rigid connectors.Non rigid connectors.
 Indicated in cases where a single path ofIndicated in cases where a single path of
insertion is cannot be achieved due to noninsertion is cannot be achieved due to non
parallel abutments.parallel abutments.
 Allow limited movement between the retainerAllow limited movement between the retainer
and the pontic.and the pontic.

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Introduction to fixed partial dentures/ online orthodontic courses

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