Details about types of Fixed Prosthesis

2. TYPES OF CROWN &
BRIDGE
Dr Yumna Shaheen Ali

3. CROWN

4. DEFINITION OF CROWN
An artificial replacement that restores missing
tooth structure by surrounding part or all of
remaining tooth structure with a material
such as metal, porcelain or combination of
materials such as metal and porcelain.

5. DIFFERENT TYPES OF CROWNS
Anterior complete crowns
for vital teeth
Anterior complete crowns
for root filled teeth
Posterior complete
crowns
Posterior partial crowns

6. A) ANTERIOR COMPLETE CROWNS FOR
VITAL TEETH
I. Ceramic Crowns
II. Metal Ceramic Crowns
III. Other types of Crowns

7. I) CERAMIC CROWNS
 Most esthetically pleasing
 No metal to block light transmission
 Can be virtually indistinguishable from
unrestored teeth

8. ADVANTAGES
 Highly aesthetic and high strength materials
 Resist plaque accumulation.
 Relative brittleness can be regarded as an
advantage specially in class 2 div I patients
where crown is most likely to fracture rather
than root.
DISADVANTAGES
 More tooth reduction
 Brittleness, in most cases is a disadvantage

9. INDICATIONS
 Where there are high aesthetic demands.
(particularly in incisal area)
CONTRAINDICATIONS
 Where more conservative restoration can be
carried out.(same for all crowns)
 Providing a shoulder of 1 mm would
compromise support.
(it should be of 2mm)

10. II) METAL CERAMIC CROWNS
Dental porcelain can be bonded to a variety of
metal alloys such as Gold, Silver, nickel etc

11. ADVANTAGES
 High strength.
 Adequate tooth reduction can be done on
palatal side in teeth which are severely
worn by erosion.
DISADVANTAGES
 As crown is stronger than natural dental
tissues so an accidental blow can result in
fracture of root.
 To achieve aesthetics margin is often
placed subgingivally, causing periodontal
problems

12. INDICATIONS
 Aesthetics
 Can serve as a retainer for fixed dental
prosthesis due to its metal substructure.
CONTRAINDICATIONS
 Active carious lesions & perio problems.
 Young patients with large pulp chambers.

13. III) OTHER TYPES OF CROWNS
 Cast metal crowns with acrylic or composite
facings.
 Fibre-reinforced composite crowns.

14. B) ANTERIOR CROWNS FOR ROOT FILLED TEETH
 Composite core & crown
 Post and core & separate crown
 One-piece post crown
 Other types (composite or metal-ceramic
crown retained by pins)

15. C) POSTERIOR COMPLETE CROWNS
I. Cast metal crowns
II. Metal-ceramic crowns
III. Ceramic crowns

16. I) CAST METAL CROWNS
Traditionally a GOLD Alloy is used for posterior
metal crowns but because of high cost many
alternative alloys are introduced containing
less gold and in some cases none.

17. ADVANTAGES
 Greater retention and resistance
 Less tooth preparation required.
DISADVANTAGES
 Poor esthetics

18. INDICATIONS
 Tooth with extensive coronal destruction
 On short clinical crowns
 Where maximum retention and resistance
is required
CONTRAINDICATIONS
 High aesthetic need

19. II) METAL CERAMIC CROWNS
Advantages
 Principal advantage is their
appearance.
 Porcelain can be used on
buccal and occlusal surfaces
of lower teeth and reverse is
true for upper jaw.
Disadvantages
 In short clinical crowns there
comes a problem of retention.
 With an amalgam core greater
reduction may expose the
pins.

20. INDICATIONS
 Aesthetics
 Retention and resistance required
CONTRA INDICATIONS
 Active carious lesions & perio problems.
 Young patients with large pulp chambers.

21. III) CERAMIC CROWNS
ADVANTAGES
 Reasonable to use with a post
and core
 Better appearance then a metal
ceramic crown
DISADVANTAGES
 More tooth preparation is required

22. INDICATIONS
 Aesthetic
CONTRAINDICATIONS
 Providing a shoulder of 1 mm would
compromise support.

23. D) POSTERIOR PARTIAL CROWNS
I. Three-Quarter Crowns
II. Seven-Eighths Crowns

24. I) THREE-QUARTER CROWNS
 They cover four-fifth
of the tooth’s surface,
buccal surface
remains intact.
 They are retained by
grooves on mesial,
distal and occlusal
surfaces.
 They are always
made of cast metal.

25. II) SEVEN EIGHTH CROWNS
 Covers all but mesial buccal cusp of an
upper molar tooth.
 Retained by intracoronal features or
adhesive techniques.

26. ADVANTAGES
 More conservative
 Possible to test vitality of tooth via buccal
surface.
 Periodontal problems are less.
DISADVANTAGES
 Preparation is bit difficult
 Less retention

27. INDICATIONS
 Teeth with sufficient bulk
 Can be used for retainers for fixed partial
denture, bridge or spring cantilever design.
CONTRAINDICATIONS
 Malpositioned teeth
 Short clinical crowns
 Teeth that are thin bucco-lingually

28. BRIDGES

29. DEFINITION OF BRIDGE
Any dental prosthesis that is luted, screwed or
mechanically attached to natural teeth, tooth
roots and/or implant abutments that furnish
primary support for dental prosthesis.

30. MATERIALS FOR CONSTRUCTION OF BRIDGE
WORK
 Metal
 Metal-ceramic
 All-ceramic
 acrylic

31. DIFFERENT TYPES OF BRIDGES
Fixed fixed
Fixed movable
Cantilever
Spring cantilever

32. A) FIXED FIXED BRIDGE
Has rigid connectors at both ends of pontics
which forms a rigid prosthesis.

33. ADVANTAGES
 Provides cross arch splinting.
 Ease of handling
DISADVANTAGES
 Possible bending of bridge
 Mobility of abutments may result in open
margins
 All units have to be cemented simultaneously

34. B) FIXED MOVABLE BRIDGE
It has a rigid connector usually at the distal end
of the pontic & a movable connector that
allows some vertical movement of the mesial
abutment tooth.

35. ADVANTAGES
 Allows flexure of mandible
 Allow units to be cemented as individual
sections.
DISADVANTAGES
 More space required
 Metal may show occlusally
 Wear of joints

36. C) CANTILEVER BRIDGE
It’s a kind of minimal preparation bridge.It
provides support for the pontic at one end
only. The pontic may be attached to a single
retainer or two or more retainers splinted
together.
e.g: maryland bridge, rochette bridge

37. ADVANTAGES
 Preserve tooth structure
 Minimal pulp trauma
 Rebond possible
DISADVANTAGES
 Length of span is limited to one pontic only.
 Occlusal forces on the pontic encourage
tilting of abutment tooth.
 Not successful for posterior prosthesis.

38. D) SPRING CANTILEVER BRIDGES
 They are restricted to the replacement of
upper incisor teeth. Only one pontic could be
supported by a spring cantilever bridge.

39. ADVANTAGES
 Restoration of spaced dentition
DISADVANTAGES
 Food impaction under metal connector
 Fracture of metal connector
 Dislodgment of retainer