adhesive bridges Flashcards
Reasons for treating tooth loss
- aesthetics
- function
- speech
- maintenance of dental health
tooth replacement options
denture
bridge
implants
What is a bridge?
a prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth (or implants)
local indications for bridgework
big teeth
heavily restored teeth
favourable abutment angulations
favourable occlusion
bridgework general contraindications
uncooperative patient
mh contraindications
poor OH
high caries rate
periodontal disease
large pulps (conventional bridge)
local contraindications for bridgework
high possibility of further tooth loss within arch
prognosis of abutment poor
length of span too great
ridge form and tissue loss
tilting and rotation of teeth
peridontal status
bone loss
degree of restoration
periapical status
What is an abutment?
a tooth which serves as an attachment for a bridge
what is a Pontic?
the artificial tooth which is suspended from the abutment tooth/teeth
what are retainers in relation to bridgework
The extracoronal or intracoronal restorations that are connected to the pontic and cemented to the prepared abutment teeth
what are connectors
component which connects the Pontic to the retainer
What is the edentulous span?
Space between natural teeth that is to be filled by a bridge or partial denture
define saddle
area of the edentulous ridge over which the Pontic will lie
What is a unit?
either a retainer or a Pontic
what is a pier?
an abutment tooth which stands between and is supporting 2 pontics, each being attached to a further abutment
Fixed-fixed bridge
type of bridge has a retainer at each end with a Pontic in the middle, joined by ridge connectors
- can be adhesive/resin bonded
- conventions
cantilever bridge
type of bridge which has a retainer (or retainers) at one side of the Pontic only
- can be resin bonded or conventional
advantages of resin bonded bridges
minimal or no preparation
no la needed
less costly
less surgery time
can be used as a provisional restoration
if fails - usually less destructive than alternatives
indications for resin bonded bridge
young teeth
- less destructive
good enamel quality
large surface area of abutment tooth
minimal occlusal load
good for single tooth replacement
simplify partial denture design
resin bonded bridge disadvantages
rigorous clinical technique
metal shine-through
chipping porcelain
can debond
- high chance of debonding again
- occlusal interference
no trial period possible
resin bonded bridge contraindications
insufficient or poor quality enamel
long spans
excess soft or hard tissue loss
heavy occlusal force e.g. bruxism
poorly aligned, tilted or spaced teeth
contact sports?
bridges - treatment planning
history
establish habits e.g. bruxism
examination
clinical
- Perio status
- radiographs
- dynamic occlusal relationships
study models
- mounted on semi-adjustable articulator
- consider diagnostic wax ups
existing restorations in abutment teeth for adhesive bridges
composite
- ok
- consider replacement prior to prep
amalgam
- compromised bond to chemically cured composite cements
- consider replacing
adhesive bridge - prep (if required)
rest seats
- posterior teeth
cingulum rests
- anterior teeth
supra gingival chamfer finish line -0.5mm
prep should ideally remain in enamel
adhesive bridge - treatment of retainer prior to cementation
try in
- fit and aesthetics
sandblasting of fitting surface of retainer
- should be done by technician
clean retainer if contaminated by unset composite resin used to try in bridge
apply anaerobic composite luting cement just prior to placement of restoration after tooth treatment
