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 different types of crowns and bridges. It describes crowns as artificial replacements that restore missing tooth structure. There are different types of crowns including anterior complete crowns, posterior complete crowns, and posterior partial crowns. Bridges are defined as dental prostheses that are attached to natural teeth or implants to provide support. Common types of bridges discussed are fixed fixed bridges, fixed movable bridges, cantilever bridges, and spring cantilever bridges. The document provides details on the characteristics, advantages, disadvantages, indications and contraindications of each crown and bridge type.
bite registration for fixed Prosthodontic restorationBotan Khafaf
This document discusses interocclusal records, including definitions, materials used, techniques, and accuracy. It describes centric relation, eccentric records, and centric occlusion. Common materials for interocclusal records include wax, zinc oxide paste, acrylic resin, and elastomeric materials like polyether and additional silicone. Elastomers are generally the most dimensionally stable and accurate. The document also discusses indications for interocclusal records and comparing methods of occlusal registration.
1. The functionally generated pathway technique involves recording the paths of tooth movement during excursive jaw motions using wax or other materials.
2. This recording is used to develop the occlusal morphology for dental restorations like crowns, ensuring optimal occlusion during all jaw motions.
3. Studies have found that the functionally generated pathway technique results in restorations with better functional articulation compared to conventional single casting techniques, with less adjustment needed and higher patient satisfaction.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
RBBs are resin-bonded bridges that are a minimally invasive option for replacing missing teeth. They are suitable for short spans of missing teeth when the patient is unwilling or unsuitable for surgery. Key factors in determining if a tooth can support an RBB include adequate size, minimal restoration, healthy periodontium, and proper angulation. The bridge design depends on factors like coverage, number of abutments, and framework rigidity. With careful case selection and attention to detail, RBBs can successfully replace missing teeth for select patients.
The document discusses various impression techniques used for dental implants. It describes the key components used, such as implant analogues and impression copings. The most common impression materials are vinyl polysiloxanes and polyether rubbers due to their dimensional stability and detail reproduction. Direct open tray techniques involve exposing the impression coping screws and incorporating the copings into the impression tray. Indirect closed tray techniques retain the copings in the mouth and reattach them to analogues in the lab. Factors like implant angulation, number of implants, and interarch space determine whether open or closed tray methods are preferred. Accurate transfer of the implant positions is crucial for passive fitting of the final prosthesis.
This document discusses different types of crowns and bridges. It describes crowns as artificial replacements that restore missing tooth structure. There are different types of crowns including anterior complete crowns, posterior complete crowns, and posterior partial crowns. Bridges are defined as dental prostheses that are attached to natural teeth or implants to provide support. Common types of bridges discussed are fixed fixed bridges, fixed movable bridges, cantilever bridges, and spring cantilever bridges. The document provides details on the characteristics, advantages, disadvantages, indications and contraindications of each crown and bridge type.
bite registration for fixed Prosthodontic restorationBotan Khafaf
This document discusses interocclusal records, including definitions, materials used, techniques, and accuracy. It describes centric relation, eccentric records, and centric occlusion. Common materials for interocclusal records include wax, zinc oxide paste, acrylic resin, and elastomeric materials like polyether and additional silicone. Elastomers are generally the most dimensionally stable and accurate. The document also discusses indications for interocclusal records and comparing methods of occlusal registration.
1. The functionally generated pathway technique involves recording the paths of tooth movement during excursive jaw motions using wax or other materials.
2. This recording is used to develop the occlusal morphology for dental restorations like crowns, ensuring optimal occlusion during all jaw motions.
3. Studies have found that the functionally generated pathway technique results in restorations with better functional articulation compared to conventional single casting techniques, with less adjustment needed and higher patient satisfaction.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
RBBs are resin-bonded bridges that are a minimally invasive option for replacing missing teeth. They are suitable for short spans of missing teeth when the patient is unwilling or unsuitable for surgery. Key factors in determining if a tooth can support an RBB include adequate size, minimal restoration, healthy periodontium, and proper angulation. The bridge design depends on factors like coverage, number of abutments, and framework rigidity. With careful case selection and attention to detail, RBBs can successfully replace missing teeth for select patients.
The document discusses various impression techniques used for dental implants. It describes the key components used, such as implant analogues and impression copings. The most common impression materials are vinyl polysiloxanes and polyether rubbers due to their dimensional stability and detail reproduction. Direct open tray techniques involve exposing the impression coping screws and incorporating the copings into the impression tray. Indirect closed tray techniques retain the copings in the mouth and reattach them to analogues in the lab. Factors like implant angulation, number of implants, and interarch space determine whether open or closed tray methods are preferred. Accurate transfer of the implant positions is crucial for passive fitting of the final prosthesis.
The document discusses the neutrocentric concept for arranging teeth in complete dentures. The neutrocentric concept proposes using flat teeth without any inclines in any direction to minimize forces that could cause denture instability. The key aspects are using a single flat plane of occlusion parallel to the residual ridges and eliminating cusps and inclines on posterior teeth to direct forces towards the supporting tissues. This concept aims to preserve residual ridge integrity by preventing destructive forces.
There are several factors that can cause the failure of crowns and fixed dental bridges, which can be classified into biological, mechanical, esthetic, and maintenance failures. Biological failures include issues like excessive pressure on soft tissues, traumatic occlusion, and lack of proper contours. Mechanical failures involve cementation problems, fractures of retainers, pontics or connectors, and wear/perforation from occlusion. Esthetic failures result from poor shading, contours or masking of metals. Maintenance failures stem from a lack of proper oral hygiene and recall exams needed to detect early signs of issues. Regular checkups are important for the long-term success of fixed dental prostheses.
The RPD is composed of teeth, a major connector, and minor connectors. It can be constructed from various metallic materials like gold alloys, cobalt-chromium, titanium, or stainless steel. Non-metallic options include thermoplastics, acrylic resins, or aryl ketone polymer. Rest seats can also be made of similar materials and are extensions that prevent movement and transmit forces to teeth. Teeth can be porcelain, acrylic, metal, or a combination, with various advantages and disadvantages for each.
Smile analysis and digital smile designSherif Sultan
This document discusses smile design and analysis. It defines key terms like esthetics, dental esthetics, cosmetic dentistry, and smile designing. Smile analysis examines the face and teeth to evaluate esthetics. Principles of esthetic dentistry include facial analysis using reference lines, dentolabial examination of the incisal edge, smile line, and buccal corridor. Proper smile design considers these facial and dental factors to enhance beauty and function.
This document provides an overview of removable partial denture (RPD) design, with a focus on the RPI and RPA systems. It discusses the challenges of tooth-tissue supported prostheses and how RPD design can control damaging forces. The RPI system aims to minimize stress using components like I-bar retainers, mesial rests, and proximal plates. Variations like Krol's modification require less tooth alteration. Indirect retention through rests helps redistribute forces. The document reviews factors like clasp design, material, and position that also influence stress control.
The document discusses various aspects of clasp design for removable partial dentures. It begins by defining what a clasp is and describing different clasp classifications such as occlusally approaching and gingivally approaching clasps. It then examines specific clasp designs like circumferential, bar/Roach type, and combination clasps. The document outlines the functional requirements of clasps, including retention, support, stability, and reciprocation. It also reviews several statements about clasp design, discussing whether prosthodontic experts agree or disagree with them based on clinical factors.
This document describes several methods for duplicating dentures, including the modified denture flask method. The key steps are:
1. Evaluating the original denture for defects and fit.
2. Attaching a wax sprue to the original denture.
3. Making an impression of the denture using alginate in a denture flask.
4. Pouring resin into the impression to duplicate the denture.
The goal is to produce a replica denture with a similar fit and appearance to replace a deteriorated original denture.
Diagnosis and treatment planning in FPD with related articlesNAMITHA ANAND
The document provides guidelines for diagnosing and treatment planning in fixed prosthodontics. It discusses the importance of a thorough history, medical/dental history, and intraoral examination to accurately diagnose a patient's condition. The intraoral exam involves assessing soft tissues, periodontal health using probing depths, tooth mobility, occlusal relationships, and radiographs. Gathering comprehensive diagnostic information allows for formulating an appropriate treatment plan based on the patient's needs.
This document discusses obturators used for acquired maxillary defects. It begins by defining an obturator and reviewing the history of obturators dating back to Ambroise Pare in the 1540s. It then covers classifications of maxillary defects, designs of obturators for different defect classes, functions of obturators, materials used, and considerations for fabrication. The document emphasizes that obturators are designed to close tissue openings, restore oral function, and rehabilitate patients with maxillary defects through adequate support, retention and stability.
The document discusses desirable occlusal contact relationships and methods for establishing occlusion for removable partial dentures. It describes five methods for establishing occlusal relationships using casts, interocclusal records, or occlusion rims. It also discusses arranging artificial teeth, establishing jaw relations when opposing a complete denture, and the importance of balanced occlusion for retention of the prosthesis.
The document discusses the definition, requirements, functions, and types of denture bases. It describes the different methods used for attaching denture bases and artificial teeth. Key types discussed are plastic acrylic and metal bases like gold or cobalt-chromium. The functions of denture bases in supporting teeth and absorbing forces are also summarized.
This document discusses provisional restorations and their requirements. It defines provisional restorations as temporary restorations designed to enhance function and aesthetics until definitive treatment. Provisional restorations must meet biological, mechanical, and aesthetic requirements. Biologically, they must protect the pulp, maintain periodontal health, and provide positional stability. Mechanically, they must resist functional loads and removal forces. Aesthetically, they must match the tooth's color, shape, and texture. The document discusses various materials used for provisional restorations including acrylic resins, bis-acryl composites, and light-cured resins.
Other forms of removable partial denture Amal Kaddah
This document discusses various types of removable partial dentures (RPDs), including unilateral RPDs, swing-lock RPDs, overlay partial dentures, implant-supported RPDs, and attachments for RPDs. It provides details on the design, indications, advantages and disadvantages of each type. Key types discussed include overlay partial dentures, which are constructed over remaining natural teeth for additional support and retention, and attachments for RPDs, which can improve retention and are either precision attachments that are prefabricated, or semi-precision attachments that are fabricated in the dental laboratory.
BASIC PRINCIPLES AND FUNDAMENTALS OF CAST PARTIAL DENTURE DESIGNINGAamir Godil
Principles of cast partial denture design
Philosophy of design
Basic guidelines for designing
Kennedy's Class I-IV designs
Indications of specific components in designing cast partial denture
Distal extension CPD
Clinical cases
Exam oriented questions
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
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
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Description :
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 document discusses the neutrocentric concept for arranging teeth in complete dentures. The neutrocentric concept proposes using flat teeth without any inclines in any direction to minimize forces that could cause denture instability. The key aspects are using a single flat plane of occlusion parallel to the residual ridges and eliminating cusps and inclines on posterior teeth to direct forces towards the supporting tissues. This concept aims to preserve residual ridge integrity by preventing destructive forces.
There are several factors that can cause the failure of crowns and fixed dental bridges, which can be classified into biological, mechanical, esthetic, and maintenance failures. Biological failures include issues like excessive pressure on soft tissues, traumatic occlusion, and lack of proper contours. Mechanical failures involve cementation problems, fractures of retainers, pontics or connectors, and wear/perforation from occlusion. Esthetic failures result from poor shading, contours or masking of metals. Maintenance failures stem from a lack of proper oral hygiene and recall exams needed to detect early signs of issues. Regular checkups are important for the long-term success of fixed dental prostheses.
The RPD is composed of teeth, a major connector, and minor connectors. It can be constructed from various metallic materials like gold alloys, cobalt-chromium, titanium, or stainless steel. Non-metallic options include thermoplastics, acrylic resins, or aryl ketone polymer. Rest seats can also be made of similar materials and are extensions that prevent movement and transmit forces to teeth. Teeth can be porcelain, acrylic, metal, or a combination, with various advantages and disadvantages for each.
Smile analysis and digital smile designSherif Sultan
This document discusses smile design and analysis. It defines key terms like esthetics, dental esthetics, cosmetic dentistry, and smile designing. Smile analysis examines the face and teeth to evaluate esthetics. Principles of esthetic dentistry include facial analysis using reference lines, dentolabial examination of the incisal edge, smile line, and buccal corridor. Proper smile design considers these facial and dental factors to enhance beauty and function.
This document provides an overview of removable partial denture (RPD) design, with a focus on the RPI and RPA systems. It discusses the challenges of tooth-tissue supported prostheses and how RPD design can control damaging forces. The RPI system aims to minimize stress using components like I-bar retainers, mesial rests, and proximal plates. Variations like Krol's modification require less tooth alteration. Indirect retention through rests helps redistribute forces. The document reviews factors like clasp design, material, and position that also influence stress control.
The document discusses various aspects of clasp design for removable partial dentures. It begins by defining what a clasp is and describing different clasp classifications such as occlusally approaching and gingivally approaching clasps. It then examines specific clasp designs like circumferential, bar/Roach type, and combination clasps. The document outlines the functional requirements of clasps, including retention, support, stability, and reciprocation. It also reviews several statements about clasp design, discussing whether prosthodontic experts agree or disagree with them based on clinical factors.
This document describes several methods for duplicating dentures, including the modified denture flask method. The key steps are:
1. Evaluating the original denture for defects and fit.
2. Attaching a wax sprue to the original denture.
3. Making an impression of the denture using alginate in a denture flask.
4. Pouring resin into the impression to duplicate the denture.
The goal is to produce a replica denture with a similar fit and appearance to replace a deteriorated original denture.
Diagnosis and treatment planning in FPD with related articlesNAMITHA ANAND
The document provides guidelines for diagnosing and treatment planning in fixed prosthodontics. It discusses the importance of a thorough history, medical/dental history, and intraoral examination to accurately diagnose a patient's condition. The intraoral exam involves assessing soft tissues, periodontal health using probing depths, tooth mobility, occlusal relationships, and radiographs. Gathering comprehensive diagnostic information allows for formulating an appropriate treatment plan based on the patient's needs.
This document discusses obturators used for acquired maxillary defects. It begins by defining an obturator and reviewing the history of obturators dating back to Ambroise Pare in the 1540s. It then covers classifications of maxillary defects, designs of obturators for different defect classes, functions of obturators, materials used, and considerations for fabrication. The document emphasizes that obturators are designed to close tissue openings, restore oral function, and rehabilitate patients with maxillary defects through adequate support, retention and stability.
The document discusses desirable occlusal contact relationships and methods for establishing occlusion for removable partial dentures. It describes five methods for establishing occlusal relationships using casts, interocclusal records, or occlusion rims. It also discusses arranging artificial teeth, establishing jaw relations when opposing a complete denture, and the importance of balanced occlusion for retention of the prosthesis.
The document discusses the definition, requirements, functions, and types of denture bases. It describes the different methods used for attaching denture bases and artificial teeth. Key types discussed are plastic acrylic and metal bases like gold or cobalt-chromium. The functions of denture bases in supporting teeth and absorbing forces are also summarized.
This document discusses provisional restorations and their requirements. It defines provisional restorations as temporary restorations designed to enhance function and aesthetics until definitive treatment. Provisional restorations must meet biological, mechanical, and aesthetic requirements. Biologically, they must protect the pulp, maintain periodontal health, and provide positional stability. Mechanically, they must resist functional loads and removal forces. Aesthetically, they must match the tooth's color, shape, and texture. The document discusses various materials used for provisional restorations including acrylic resins, bis-acryl composites, and light-cured resins.
Other forms of removable partial denture Amal Kaddah
This document discusses various types of removable partial dentures (RPDs), including unilateral RPDs, swing-lock RPDs, overlay partial dentures, implant-supported RPDs, and attachments for RPDs. It provides details on the design, indications, advantages and disadvantages of each type. Key types discussed include overlay partial dentures, which are constructed over remaining natural teeth for additional support and retention, and attachments for RPDs, which can improve retention and are either precision attachments that are prefabricated, or semi-precision attachments that are fabricated in the dental laboratory.
BASIC PRINCIPLES AND FUNDAMENTALS OF CAST PARTIAL DENTURE DESIGNINGAamir Godil
Principles of cast partial denture design
Philosophy of design
Basic guidelines for designing
Kennedy's Class I-IV designs
Indications of specific components in designing cast partial denture
Distal extension CPD
Clinical cases
Exam oriented questions
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
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
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Description :
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 options for connecting dental restorations to abutments and implants, including the biologic and technical issues involved. It compares screw-retained, cement-retained, and screwless systems. It also discusses arguments in favor of cementation, potential problems like cement accumulation, and the limits of cement retention related to factors like abutment angulation and axial wall height. Finally, it covers custom abutments, platform switching, and the next generation of the UCLA abutment using shape memory alloys.
This document discusses factors to consider when evaluating teeth as potential abutments for fixed partial dentures (FPDs). It defines key terms like abutment and describes the ideal requirements for an abutment tooth, including that it is vital, has adequate coronal structure and healthy surrounding tissues. The document outlines how to assess abutments clinically, with diagnostic casts and radiographs. It discusses many factors that influence abutment selection, like crown length, ratio of crown to root, root configuration, proximity between roots, periodontal health and mobility. It also addresses how span length, arch curvature and other anatomical traits should guide abutment choices to help ensure the FPD's long-term success.
This document discusses single tooth defects in the posterior quadrants and their restoration. It compares fixed dental prostheses to implants, noting that implants are generally preferred when adjacent teeth are healthy or nearly so. For endodontically treated teeth, a fixed restoration is preferred if sufficient tooth structure remains and occlusion and parafunction are minimal. Considerations for implant placement include anatomic factors, timing of placement, and prosthodontic issues like abutment selection and cement versus screw retention. The goal is to restore function while avoiding complications like fracture, overload, and peri-implantitis.
Attachments in removable partial prosthesishamide norouzi
An attachment is a connector used in removable and fixed prosthodontics that consists of two parts: a female part attached to a tooth, implant, or ridge that acts as a retainer, and a male part attached to the prosthesis. Attachments are classified based on their location, fabrication method, retention mechanism, and degree of movement allowed. Key factors to consider when selecting an attachment include the condition of the abutment teeth and ridge, space available, and the patient's dexterity. Common attachment types include intracoronal, extracoronal, stud, bar, and telescopic attachments.
This document discusses prosthodontic procedures and complications in posterior quadrants. It covers topics such as exam and workup, selection of implants, platform switching, abutment selection, provisional restorations, and new technologies like shape memory sleeve abutments. Key points addressed include that no implant design has been proven superior for marginal bone loss, and custom abutments offer better control of margins and occlusal thickness than prefabricated abutments. New technologies aim to simplify procedures and improve retrievability of restorations.
Abutment /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Description :
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
Long Island Periodontist presents "Dental Implant Abutment Impression and Del...Edward Brant DDS, MS
This document provides tips for chair-side time saving and confidence raising techniques during the abutment phase of implant prosthetics. It discusses how implant dentistry requires learning new terminology from different manufacturers. Details are often glossed over in lectures. Training is typically "on the job" rather than formal. The document reviews armamentarium for the first visit, compares custom vs premachined abutments, and provides tips for inspection, impression taking, and lab prescriptions to improve efficiency and outcomes. Key steps discussed include gentle handling of tissues, noting implant positions, and using tools like needle holders to securely place and remove components.
Telescopic milled PFM\'s to seat claspless RPD\'s.Mike Tapealava
This is a power point presentation of a case presented from the postgraduate prosthodontic students. All technical work was done at the University of Otago.
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.
The document discusses factors to consider when selecting abutment teeth for fixed partial dentures. Key factors include the location, position, and condition of the tooth, as well as characteristics of the crown, root, supporting bone, and periodontal ligament area. Ideal abutment teeth are those adjacent to edentulous spaces, have sufficient root length and structure, and provide adequate periodontal ligament area to support the prosthesis based on Ante's law. Abutment teeth should be vital or endodontically treated as needed and have healthy bone support.
Recent advances in orthodontics allow for better treatment results with fewer visits and shorter treatment times. New materials like self-ligating brackets, nickel-titanium wires, and bonding agents that adhere to porcelain provide more options with less friction and faster tooth movement. Digital technologies and customized clear aligners also give orthodontists modern solutions to longstanding challenges of dental alignment and jaw development.
1. The document describes the IS Implant System product line including dental implants, abutments, and related components.
2. A variety of implant fixtures are presented varying in diameter, length, surface type, and platform size to accommodate different clinical situations.
3. Components like healing abutments, temporary abutments, and lab tools for prosthetic procedures are also detailed.
4. Product names, dimensions, and intended uses are provided for each item to allow dentists to select the appropriate implant and prosthetic solutions.
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, aerobic exercise was shown to improve executive function and memory in the study participants between the ages of 60-75 who exercised at least 30 minutes per day for 6 months.
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.
Screw versus cement for implant prosthesis installation part 2Emil Svoboda
Screw versus Cement, dental implants, 2015, Implant Prosthetics, Crowns and Bridges, Cementation, Screw retained Part 2
Citation:
Screw versus Cement for Implant Prosthesis Installation. Part 2: The Game Changer the Tips the Balance to Favour Intra-oral Cementation. Emil LA Svoboda, Published to www.ReverseMargin.com, November 12, 2015
Facial implant and implant retained craniofacial prostheses nnPallawi Sinha
This document discusses implant-retained craniofacial prostheses. It covers the advantages of maxillofacial implants over conventional adhesives for prosthesis retention. It also discusses patient assessment, treatment planning, surgical techniques for implant placement, different types of craniofacial prostheses (auricular, ocular, nasal, midfacial), abutment sites, follow-up care, and a review of literature on the topic. The document focuses on osseointegrated implants as a method for retaining craniofacial prostheses and improving patients' quality of life.
Biomechanics in fixed partial prosthodontics /certified fixed orthodontic cou...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.
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
Treatment planning and diagnosis for fpd / oral surgery courses 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.
Single complete dentures /orthodontic courses by Indian dental academy 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
www.indiandentalacademy.com
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.
This document discusses treatment options for missing maxillary central incisors. It describes various causes for missing central incisors including trauma, decay, fractures, and extractions. The main treatment options discussed are removable partial dentures and fixed partial dentures. Removable partial dentures are less invasive but can cause damage to tissues over time and require good oral hygiene. Fixed partial dentures like conventional bridges or resin-bonded bridges offer a more permanent solution but require more tooth preparation. Implant-supported bridges are also mentioned as a treatment option.
The document discusses various factors to consider when planning and performing tooth crowning procedures. It covers evaluating tooth structure and integrity, risk factors, endodontic treatment status, periodontal health, occlusion, and margin placement. It emphasizes the importance of a ferrule effect to provide resistance and longevity when using posts. Short teeth require special consideration of their position, function, and potential for surgical or orthodontic treatment prior to restoration. Proper treatment planning based on a thorough examination is necessary for successful crowning outcomes.
Description :
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
Description :
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
Description :
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 single complete dentures opposing natural teeth. It defines a single complete denture as a prosthesis that replaces all lost teeth in one arch. Challenges include managing high occlusal forces from natural teeth and accommodating the occlusal form of remaining teeth. Diagnosis requires evaluating support, interarch relationships, and preserving remaining structures. Various combinations are described, like a maxillary complete denture opposing natural mandibular teeth. Methods to achieve balanced occlusion include functional jaw movements to record occlusal schemes or articulator-based equilibration.
This document discusses single complete dentures opposing natural teeth. It defines a single complete denture as a prosthesis that replaces all lost teeth in one arch. Challenges include high occlusal forces from natural teeth and maintaining support. Diagnosis considers the remaining teeth and a treatment plan to preserve them. Combinations include a maxillary complete denture opposing mandibular natural teeth. Achieving balanced occlusion requires evaluating the natural tooth form and positions, and may involve equilibrating the articulator or functional jaw movements during try-in.
This document discusses crowding in mixed dentition and various treatment options. It begins by explaining that crowding is a primary reason parents bring children to the dentist. For mild crowding under 4mm, a lower lingual arch or palatal holding arch can be used to prevent need for future orthodontics. Patients predicted to have over 5mm of crowding should be referred to an orthodontist. Space loss can be addressed through observation, disking primary teeth, extractions, or corrective orthodontics. The document discusses various space maintainers and appliances that can be used for different clinical scenarios to address crowding and space management in mixed dentition.
Tooth-to-Implant Supported Fixed Partial Dentures- A Comprehensive Overview.pptxFaryal Afzal
Tooth to Implant Supported Fixed Partial Dentures.
OBJECTIVE:
Tooth-to-implant–connected prostheses have been described as a possible treatment option for patients with long-span edentulous situations that were not conducive for placement of an adequate number of supporting implants. In this comprehensive overview of systematic reviews, the incidence of complications and the long-term survival rates of tooth-to-implant–supported fixed partial dentures (FPDs) were evaluated to determine whether it is a viable treatment.
abutment selection in fixed partial denture.pptxRajSalvi5
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures. Thorough diagnostic evaluation including diagnostic casts, radiographs and clinical examination are needed to assess root morphology, bone support, crown-root ratios and other anatomical and pathological factors. Proper identification of abutment teeth requires consideration of these diagnostic factors as well as other issues like occlusion, opposing dentition and esthetics to design fixed prostheses that are retained and supported by abutment teeth.
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Rationale for dental implants /certified fixed orthodontic courses by Indian ...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.
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
This document discusses guidelines for evaluating teeth as abutments for fixed dental prostheses. It defines an abutment and ideal requirements, such as that an abutment should be vital with sufficient coronal structure and healthy supporting tissues. Abutments are examined clinically and radiographically. Key factors reviewed include the crown-root ratio, root configuration, surface area, and the condition of the crown. Special considerations for certain abutment types like tilted molars and cantilever situations are also covered. The document emphasizes that abutment selection requires a thorough evaluation to identify teeth that can withstand the additional stresses of supporting a fixed prosthesis.
Maxillary lateral incisors are the second most commonly congenitally missing teeth. When they are missing, orthodontic treatment can either open space to replace the tooth with an implant later, or close the space and substitute the canine. Selecting the best option depends on factors like malocclusion and tooth sizes. For opening space, implants are usually placed after growth is complete, so it is important to monitor eruption and implant site development early. Ankylosed primary molars can also affect future implant placement if not addressed. The orthodontist must consider various factors like age, gender, and tooth development when deciding how to manage congenitally missing teeth and ankylosed primary molars in adolescent patients.
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Leader in continuing dental education
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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
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
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Selection and choice of abutments/ dental implant courses
1. SELECTION AND CHOICE OF
ABUTMENT
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com
2. Abutment Evaluation
Abutment teeth are called upon to withstand the
forces normally directed to the missing teeth, in
addition to those usually applied to the abutments.
Whenever possible, an abutment should be a vital
tooth. However, a tooth that has been
endodontically treated and is asymptomatic, with
radiographic evidence of good seal and complete
obturation of the canal, can be used as an abutment.
The tooth must have some sound, surviving coronal
tooth structure to insure longevity. However, some
compensation can be made through the use of a
dowel core, or a pin retained amalgam or a
composite core.
www.indiandentalacademy.com
3. Teeth that have been pulp capped in the process of
preparing the tooth should not be used as an FPD
abutment unless they are endodontically treated.
The supporting tissues surrounding the abutment
teeth must be healthy and free from inflammation
before any prosthesis can be contemplated.
Normally, abutment teeth should not exhibit any
mobility, since they will be carrying an extra load.
The roots and the supporting tissues should be
evaluated for three factors:
• Crown-root ratio.
• Root configuration.
• Periodontal ligament area.www.indiandentalacademy.com
4. Crown-root ratio
This ratio is a measure of the length of tooth,
occlusal to the alveolar crest of bone compared with
the length of root embedded in the bone. As the
level of alveolar bone moves apically, the lever arm
of that portion out of bone increases, and the
chances for harmful lateral forces is increased. The
optimum crown-root ratio for a tooth to be utilized
as a FPD abutment is 2:3. A ratio of 1:1 is the
minimum ratio that is acceptable for a prospective
abutment under normal circumstances.
www.indiandentalacademy.com
5. However, there are situations in which a crown
root ratio greater than 1:1 might be considered
adequate. If the occlusion opposing a FPD is
composed of artificial teeth, occlusal forces will be
diminished, with less stress on the abutment teeth.
The occlusal forces against prosthetic appliances
have been shown to be considerably less than that
against natural teeth: 26 lb for removable partial
dentures and 56 lb for fixed partial dentures versus
150 lb for natural teeth.
www.indiandentalacademy.com
6. For the same reasons, an abutment tooth with a
less than desirable crown-root ratio is more
likely to successfully support FPD if the
opposing occlusion is composed of mobile,
periodontally involved teeth than if the teeth
are periodontally sound.
www.indiandentalacademy.com
7. Root configuration
This is an important point in the assessment of an
abutment’s suitability from a periodontal standpoint.
Roots that are broader labiolingually than they are
mesiodistally are preferable to roots that are round
in cross-section.
www.indiandentalacademy.com
8. Multirooted posterior teeth with widely separated roots will
offer better periodontal support than roots that converge,
fuse, or generally present a conical configuration. The tooth
with conical roots can be used as an abutment for a short
span FPD if all other factors are optimal. A single rooted
tooth with evidence of irregular configuration or with some
curvature in the apical third of the root is preferable to the
tooth that has a nearly perfect taper.
www.indiandentalacademy.com
9. Periodontal ligament area / Ante’s law
When the normal complement of roots is not
available to distribute the forces of mastication,
pathologic stress concentrations may result in the
periodontal ligament and supporting bone. This
condition is the most fundamental problem with
which the dentist must contend each time a fixed
prosthesis is designed to replace a missing tooth.
Here we must take into accounts Ante’s law, which
states, “The total periodontal membrane area of the
abutment teeth should equal or exceed that of the
teeth to be replaced’’.
www.indiandentalacademy.com
10. The essential feature of this clinical guideline is that
the actual area of the interface between tooth and
supporting structures must be of a certain minimal
amount to withstand and resist the forces that will
now be transmitted to those supporting structures.
Realistic determination of the area of good, healthy,
periodontal ligament available on a potential FPD
abutment is not an easy matter.
www.indiandentalacademy.com
11. The combined root surface area of the second
premolar and the second molar (A2p+A2m) is
greater than that of the first molar being
replaced (A1m).
www.indiandentalacademy.com
12. The combined root surface area of the first
premolar and the second molar abutment
(A1p+A2m) is approximately equal to that of
the teeth being replaced (A2p+A1m).
www.indiandentalacademy.com
13. The combined root surface area of the canine
and the second molar (Ac+A2m) is exceeded
by that of the teeth being replaced
(A1p+A2p+A1m)
www.indiandentalacademy.com
14. Also of extreme importance is the actual area of contact
between the periodontal structures and the root in question
as it relates to the normal amount of contact area for that
particular tooth in that particular mouth. One can assume
that in a given case, without bone loss, the area of this
contact is optimal. Therefore, any loss of bone support
compared with the optimal situation decreases the chances
of this root being an adequate bridge abutment. If one looks
at the problem in this manner, it becomes apparent that a
root that appears adequate in one situation may be
inadequate in another. The planning and design of a
restoration of this type must have the benefit of sound
clinical judgment and knowledge of basic biomechanical
principles.
www.indiandentalacademy.com
15. Maxillary Maxillary Mandibular Mandibular
Tooth Area mm2 Ranking Area mm2 Ranking
Central 139 7 103 8
Lateral 112 8 124 7
Canine 204 3 159 4
First premolar 149 5 135 6
Second
premolar
140 6 135 5
First molar 335 1 352 1
Second molar 272 2 282 2
Third molar 197 4 190 3
Comparison of root surface areas of 16 teeth
www.indiandentalacademy.com
16. The above table, which compares the root surface
areas of 16 teeth, may aid in visualizing root areas.
It is interesting to note that the addition of abutment
roots will provide a wide variation of additional
support. The addition of such support is not
necessarily proportional to the number of abutments
supporting prosthesis. There fore, the prosthodontist
should not expect a proportional increase in stress-
bearing ability, particularly when the amount of
periodontal ligament is reduced.
www.indiandentalacademy.com
17. The area of the normal periodontal ligament (PDL)
for teeth to be replaced by pontics should be less
than the actual PDL area of the existing abutment
candidates.
The values given in the table are averages for the
various teeth in the mouth under ideal conditions.
Two problems are evident when one attempts to
arrive at useful interpretation of such data.
www.indiandentalacademy.com
18. Degree and nature of bone loss
In clinical practice, the decision making process in
which root surface area information is to be used
does not always involve ideal situations. More
often than not, there has been some bone loss; thus,
a tooth with a moderate amount of bone loss may be
still a better candidate for use as a FPD abutment
than another tooth with no bone loss at all. To
determine as to which of the teeth in question has
adequate support for the anticipated loads, there are
few aids on which the dentist can rely, none of them
capable of giving all the information necessary to
make a decision. www.indiandentalacademy.com
19. These aids are
• Radiographs
• Periodontal probing, and
• Mobility tests.
The radiograph is unquestionably the most useful tool at
the disposal of the dentist in making a determination of
the integrity of the remaining periodontal supporting
structures as related to the loads anticipated. The
opportunity to make radiographs from different projection
angles should not be overlooked, since the primary areas
that can be visualized on radiographs are the mesial and
distal surfaces. Any chance for seeing even a little of the
facial or lingual surfaces should be taken advantage of.
www.indiandentalacademy.com
20. Periodontal probing is the second tool at the disposal at the
dentist and should be used extensively when attempting to
determine the efficacy of using a given tooth as an
abutment. Periodontal probing is a particularly important
step as related to the facial and lingual surfaces, since these
areas of the tooth to supporting structures interface cannot
be viewed adequately on the radiograph.
Finally, standard clinical tests for mobility should be
employed. Any degree of mobility outside the normal
accepted physiologic range should be suspected. It means
either that the loss of supporting structure, whether or not
fully appreciated from the radiographs and probing, is
severe enough to alter physically the stability of the tooth or
that the occlusion has traumatically loosened the tooth.
www.indiandentalacademy.com
21. It is very important to understand which of these processes
is at work in a given abutment situations. Occlusal trauma
is usually reversible, and given the fact that the
prosthodontist is going to construct a restoration on the
tooth in question, there is ample opportunity to correct the
situation. A periodontal defect, however, is not always
reversible and depending on its severity may require a
drastic alteration of the plan of treatment for the tooth in
question. The important concept to keep in mind is that the
prosthodontist must exercise a certain degree of good
judgement in the question of interpretation of the adequacy
of supporting structures in a given situations. Many aspects
of the final restoration and the chances for success are
basically technical and depend on the skill of a particular
prosthodontist. Not only good judgment but a conservative
approach must be hall marks of the thought processes of the
dentist in this all important consideration.www.indiandentalacademy.com
22. Ante’s law says that in a situation where the
preceding values are normal, prosthesis to replace
the maxillary first molar would need abutment teeth
with at least 335 mm2 of periodontal membrane.
This requirement is theoretically well satisfied in the
case because of the total average area of the second
molar and second premolar is 412mm2, however,
has there been enough loss of bone on these two
teeth to result in, for example, a total of only
300mm2, the law would not be satisfied.
www.indiandentalacademy.com
23. Tilted molar abutment
Titled abutment teeth are a common problem that
must be addressed in construction of fixed partial
prostheses. The tooth to be replaced by the
restoration frequently has been missing for a long
time. Therefore, the tooth distal to the missing one
often will have tilted into the space. It is impossible
to prepare the abutment teeth for a fixed partial
denture along the long axis of the respective teeth
and achieve a common path of insertion. There is
further complication if the third molar is present. It
will usually have drifted and tilted with the second
molar. www.indiandentalacademy.com
24. Because the path of insertion of the fixed partial denture
will be dictated by the smaller premolar abutment, it is
probable that the path of insertion will be nearly parallel
to the former long axis of the molar abutment before it
tilted mesially. As a result, the mesial surface of the
tipped third molar will encroach upon the path of
insertion of the fixed partial denture, thereby preventing
it from seating completely.
www.indiandentalacademy.com
25. Some of the possible solutions to these problems
are:
Preparation modifications: The design of the
preparation could be modified to be in harmony
with the line of draw requirements of the other
abutment and adjacent teeth while at the same time
satisfying all other preparation criteria, such as
retention and protection of the pulp. A proximal half
crown can be used as a retainer on the distal
abutment. This retainer can be used only if the distal
surface itself is untouched by caries or
decalcification and if there is very low incidence of
proximal caries throughout the mouth.www.indiandentalacademy.com
26. If there is a severe marginal ridge height
discrepancy between the distal of the second molar
and the mesial of the third molar as a result of
tipping, the proximal half crown is
contraindicated.
www.indiandentalacademy.com
27. Telescopic crown designs: A two piece restorations is
constructed whereby the line of the draw of one
component (seated on the tipped tooth preparations) is
such that it favors the tooth. The line of the draw of the
component is then in harmony with the other abutment
preparation.
www.indiandentalacademy.com
28. Broken connectors: In these situations it is
desirable to connect units of fixed bridges in
some manner that will allow the various
components of the prosthesis to be seated
separately.
www.indiandentalacademy.com
30. Composite resin bonded prosthesis
The most recent innovation in multiple unit
restorations is the composite resin bonded
prosthesis. Utilization and popularization of this
technique is based on the ability to etch certain high
modulus, non precious alloys. After etching, the
metal can be placed after only a minimum of tooth
reduction. To accomplish the goals of this
conservative restoration, one must make the metal
frame work thin and in-conspicuous which has led
to FPD’s with minimal structural integrity.
www.indiandentalacademy.com
31. The essential features of this type of restoration
have included:
• Minimal axial reduction lingually at the height of
contour.
• 1 mm deep occlusal rests inclined toward the
center of the abutment teeth.
• 180-degree proximal wraparounds approximately
0.4mm thick.
• A distinct path of insertion.
• For anterior abutments, bonded cingulum rests
have been advocated.
www.indiandentalacademy.com
33. When these composite resin bonded prosthesis are
subjected to occlusal loadings, very high complex
stresses are generated at the connector areas and
extend into the high flexure of the wraparound arms.
These high flexural stresses are transmitted to the
resin adhesive. During function, the bridge is
subjected to a large number of chewing cycles,
which may be translated into fatigue failure of the
adhesive layer
www.indiandentalacademy.com
34. When the thickness is increased, a substantial
decrease in the level of stress concentration results.
Another means to substantially reduce the level of
stresses within the frame work is to include
occlusogingival extensions adjacent to the
extraction site.
The occlusal rests are also important structural
elements in the transmitting of forces from the
pontic to the abutment teeth. A similar structural
support may be obtained by preparing a ledge on
which the occlusogingival extension rests. This
support is, in essence, a very minor box preparation.
There are pros and cons to both approaches, but one
of these two rest concepts should be used.
www.indiandentalacademy.com
35. Structural considerations for the success of this
technique should include:
• Wraparound arms as thick as possible consistent
with reasonable tooth contour.
• Occlusogingival proximal extensions and
• A sound rest, whether it is on the occlusal surface
or in the form of a gingival box.
www.indiandentalacademy.com
36. Canine replacement fixed partial dentures
Fixed partial dentures replacing canines can be difficult
because the canine often lies outside the interabutment axis.
The prospective abutments are the lateral incisors, usually
the weakest tooth in the entire arch, and the premolar, the
weakest posterior tooth. A fixed partial denture replacing a
maxillary canine is subjected to more stresses than that
replacing a mandibular canine, since forces are transmitted
outward (labially) on the maxillary arch, against the inside
of the curve (its weakest point).
www.indiandentalacademy.com
37. On the mandibular canine, the forces are directed
inward (lingually), against the outside of the curve
(its strongest point).
Any fixed partial denture replacing a canine should be
considered a complex a fixed partial denture. No fixed partial
denture replacing a canine should replace more than one
additional tooth. An edentulous space created by the loss of a
canine and any two contiguous teeth is best restored with a
removable fixed partial denture.www.indiandentalacademy.com
38. Cantilever fixed partial dentures
A cantilever fixed partial denture is one that has an
abutment or abutments at one end only, with the other end
of the pontic remaining unattached. This is a potentially
destructive design with the lever arm created by the pontic.
In a routine three-unit fixed partial denture, force that is
applied to the pontic is distributed equally to the abutment
teeth. If there is only one pontic and it is near the
interabutment axis line, less leverage is applied to the
abutment teeth or to the retainers than with a cantilever.
When a cantilever pontic is employed to replace a missing
tooth, forces applied to the pontic have an entirely different
effect on the abutment tooth. The pontic acts as a lever that
tends to be depressed under forces with a strong occlusal
vector.
www.indiandentalacademy.com
40. Prospective abutment teeth for cantilever fixed partial
dentures should be evaluated with an eye towards lengthy
roots with a favorable configuration, long clinical crowns,
good crown-root ratios, and healthy periodontium.
Generally, cantilever fixed partial dentures should replace
only one tooth and have at least two abutments.
A cantilever can be used for replacing a maxillary lateral
incisor. There should be no occlusal contact in either centric
or lateral excursions. The canine must be used as an
abutment, and it can serve in the role of solo abutment only
if it has a long root and good bone support. There should be
a rest on the mesial of the pontic against a rest seat
preparation in an inlay or other metallic restoration on the
distal of the central incisor to prevent rotation of the pontic
and the abutment. www.indiandentalacademy.com
41. The mesial side of the pontic can be little ‘wrapped around’
the distal portion of the uninvolved central incisor to
stabilize the pontic faciolingually. The root configuration of
the central incisor does not make it a desirable cantilever
abutment.
www.indiandentalacademy.com
42. A cantilever pontic can also be used to replace a missing
first premolar. This scheme will best work if occlusal
contact is limited to the distal fossa. Full veneer retainers
are required on both the second premolar and first molar.
These teeth must exhibit excellent bone support. This design
is acceptable if the canine is unmarred and if a full veneer
restoration is required for the first molar in any event.
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43. Cantilever fixed partial denture can also be used to replace
molars when there is no distal abutment present. When used
judiciously, it is possible to avoid the insertion of a
unilateral removable partial denture. Most commonly, this
type of fixed partial denture is used to replace the first
molar, although occasionally it is used to replace a second
molar to prevent supereruption of opposing teeth. When
pontic is loaded occlusally, the adjacent abutment tends to
act as a fulcrum, with a lifting tendency on the farthest
retainer. To minimize the leverage effect, the pontic should
be kept as small as possible, more nearly representing a
premolar than a molar. There should be a light occlusal
contact with absolutely no contact in any excursion. The
pontic should possess maximum occlusogingival height to
ensure a rigid prosthesis.www.indiandentalacademy.com
44. A posterior cantilever pontic places maximum demands on the
retentive capacity of the retainers. Its use, therefore, should be
reserved for those situations in which there is adequate clinical
crown length on the abutment teeth to permit preparations of
maximum length and retention. The success of cantilevers in the
restoration of the periodontally compromised dentition is
probably due, at least by part, to the fact that periodontally
involved abutments do have extremely long clinical crowns.
While cantilever fixed partial dentures appears to be a
conservative restoration, the potential for damage to the
abutment teeth requires that they be used sparingly.
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45. Double abutment
Many clinical situations require the use of double
abutments in the fixed bridges. The term as used here
refers to the use of two adjacent teeth at one or both ends
of a fixed prosthesis joined by a solid connector. The
usual reasons for use of double abutment are:
• Increase retention of the restorations as a whole
• Splint and stabilize periodontally compromised teeth and
• Increase the area of the supporting PDL and bone.
Improvement of the retentive aspects of the restoration
would seem to be a reasonable justification for including
an extra abutment. This rationale is not always true. As
seen, the second premolar has insufficient coronal dentin
to provide the necessary retention for use as an abutment.
Th assumption was made that adding the extra premolar
abutment would give the bridge adequate retention of the
anterior end.
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46. This abutment would allow retention of the second
premolar root to reduce future bone loss, which
would occur if this tooth were extracted. This latter
point would certainly add credibility to the rationale,
but at least two other more conservative methods
could be considered to render the second premolar a
sound abutment. First, a pin retained intra coronal
casting or build up could be made for the second
premolar if maintenance of the vitality of this tooth
is a prime concern. Second, endodontic therapy and
a retentive post and core could be done on the
second premolar. The latter method would usually
be the method of choice in this situation due to the
greater chance of long term success compared with
the pin buildup. www.indiandentalacademy.com
47. Either of these options, particularly the post and core, could
obviate the need for double abutting this restoration. The
reason being that by correcting the problem involving the
second premolar, which is lack of retention, the operator has
created a typical three unit prosthesis situation. The preceding
example considered the use of double abutment strictly on the
basis of lack of retention of the primary abutment choice. A
discussion of other reasons for the use of multiple abutments
follows. However, before proceeding, it is advisable to
consider some of the ramifications of using double abutment
as a solution for lack of abutment retention.
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48. During function, the case treated as shown, often
develops a cement failure at the second premolar
because of poor retention characteristics. The other
units will often be retained adequately. Breakdown
of the cement layer of this abutment tooth leads to
slow destruction by action of the saliva and its
acidic components. Had this same loss of retention
occurred in the case of a single unit restoration, it
would have simply come away from the preparation
and the patient would have sought treatment for an
obvious problem. Dislodgement of the restoration
does not occur, however, when other retainers of a
multiple unit restoration remain in place on their
respective abutment teeth.
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49. This problem is difficult to diagnose because “loose”
retainer is still held in its correct position in relation to the
abutment tooth, though no longer cemented. The patient
complains of pain. Since the retainer is still held in its
correct position relative to the abutment tooth preparation,
no marginal opening can be detected, nor can any looseness
or movement.
As can be easily seen, diagnosis of the patient’s complaint
can be difficult, if not impossible, without removal of the
entire restoration. Due to these problems, it is imperative
that precautions be taken in the design and construction of
multiple unit restorations to preclude the loss of retention on
any abutment. Further it is strongly recommended that the
use of double abutments to compensate for lack of retention
on one of the abutment teeth of a fixed prosthesis be
discouraged.
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50. The procedure may be justified from the view point of
maintaining bone, but it is less justifiable when considered
in the light of resistance to the forces to which the
restoration will ultimately be subjected. The alternative of
pins or posts will usually be found to be the treatment of
choice to permit saving of the root.
Splinting and stabilization of a periodontally compromised
tooth can be more valid reasons for the use of double
abutments on a fixed bridge. However, a fundamental
decision must be made early in the planning of the case; is
the mobility the result of a continuing process of
periodontitis, or occlusal trauma. If the mobility of the tooth
is only the result of occlusal trauma, stabilization of such a
tooth in this manner may be perfectly justified, providing
that the trauma can be eliminated in the occlusal scheme of
the restorations.
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51. When a tooth is subjected to occlusal forces that
cannot be controlled, the adjacent tooth might be
added to the restoration as a double abutment to
provide the needed resistance to lateral forces. A
classic example on this situation would be a bridge
replacing a missing maxillary canine. In such a
case, the lateral occlusal forces generated on the
canine pontic are such that the lateral incisor is
seldom an adequate abutment due to its short root
form. It is then justified to add the central incisor to
such design. It has been shown that mobility
resulting from occlusal trauma is reversible once the
cause for the trauma is removed.www.indiandentalacademy.com
52. On the other hand, if the lack of bone support is due
to periodontal disease, and if the disease is not
totally controlled, using this tooth as part of double
abutment is contraindicated. In such a situation,
bone loss on the affected abutment tooth continues,
with the end result being that this tooth eventually
becomes simply another pontic in the bridge. Also,
pockets become less cleanable after the placement
of the restoration due to poorer access,
compounding the problem.
Finally, the best justification, for using double
abutments is to satisfy Ante’s law. If there are not
enough periodontal ligaments for a given number of
missing teeth, there is no better solution than to add
one or more teeth that do have sound support.www.indiandentalacademy.com
53. When many missing teeth are replaced by a fixed
restoration using a limited number of abutments,
most of which do not even possess the normal
amount of bone support, failure is assured. One
must make decision whether the addition of more
abutments in the design of the restoration is more
important than satisfying the concomitant
requirement for conservatism. There may be no
choice if the restoration is to be made at all. If it is
not possible to satisfy Ante’s law in this regard, a
removable partial denture should be considered so
that occlusal forces may be distributed cross arch
and to the edentulous ridges.www.indiandentalacademy.com
54. From the viewpoint of mechanical principles, the advantage
of adding a second abutment at one end of a fixed prosthesis
is that in so doing, we are better able to distribute the forces
that would be applied to the prosthesis. Nothing would be
gained if a crown were placed on the added abutment were
it not connected rigidly to the remainder of the prosthesis.
When the added tooth is made an integral part of the
prosthesis, its periodontal ligaments provide resistance to
forces transmitted by the other abutment at this end of the
bridge. This shared load-bearing responsibility is the
essence of Ante’s law. An additional abutment tooth, or
teeth, is used to replace the missing tooth. Other wise, only
two abutment teeth would be performing the function of
resisting forces applied to three occlusal surfaces.
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55. There is a common problem in replacing all four
maxillary incisors with a fixed partial denture and
the problem is more pronounced in the arch that is
pointed in the anterior. This occurs because the
pontics lie outside the interabutment axis line and
thus acts as a lever arm, which can produce a
torquing movement. In order to offset the torque,
additional retention is obtained in the opposite
direction of the lever arm and at a distance from the
interabutment axis equal to the length of the lever
arm.
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56. The first premolars sometimes are used as secondary
abutments for a maxillary four-pontic canine to
canine fixed partial denture. Because of the tensile
forces that will be applied to the premolar retainers,
they must have excellent retention.
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