Bridges

Question 1

What is a bridge?

Answer 1

A fixed dental restoration that replaces one or more teeth

Question 2

What are the 3 reasons for placing a bridge?

Answer 2

Aesthetics
Occlusion
Arch stability

Question 3

What are the advantages of a RRB?

Answer 3

Minimal to no prep
Lower cost than implants or conventional bridge
Fixed option

Question 4

What are the disadvantages of RRBs?

Answer 4

Debonding
Longevity

Question 5

What are the indications of an RRB?

Answer 5

Good abutments
Favourable occlusion
Short span bridge (1 unit)

Question 6

What are the advantages of a conventional bridge?

Answer 6

Fixed
Aesthetics

Question 7

What are the disadvantages of a conventional bridge?

Answer 7

Tooth prep
More costly than a RRB

Question 8

What are the indications for a conventional bridge?

Answer 8

Restored abutments
Adequate space

Question 9

What are the contraindications for any bridge?

Answer 9

Poor OH
Uncontrolled perio
Uncontrolled caries
Too many missing teeth
Unrestorable abutments
Abutments which are not parallel
Hazardous activities - boxers, rugby players
Economics
Unable to open for the duration of treatment

Question 10

What are the advantages of removable denture?

Answer 10

Cheaper
Can replace large numbers of teeth
Non invasive
Easier cleaning

Question 11

What are the disadvantages of dentures?

Answer 11

Bully
Patient tolerance
Aesthetics

Question 12

What are the indications for dentures?

Answer 12

Replacing long spans of teeth
Provisional restorations

Question 13

What are the contraindications?

Answer 13

Patient tolerance

Question 14

What are the advantages of an implant?

Answer 14

Does not damage adjacent teeth
Aesthetic
Gold standard for replacing a single tooth

Question 15

What are the disadvantages of implants?

Answer 15

Costly
Requires surgery

Question 16

What are the indications for implants?

Answer 16

Congenitally missing teeth
Divergent abutments
Good bone levels

Question 17

What are the contraindications for implants?

Answer 17

Inadequate bone
Patients MH
Anatomy - close to floor of sinus

Question 18

What materials can bridges be made from?

Answer 18

Metal
Ceramic
PFMs

Question 19

Describe a fixed-fixed bridge

Answer 19

Retainer at either end
Pontics lie between retainers
Rigid connector joins pontic to retainer

Question 20

Describe a cantilever bridge

Answer 20

Retainer(s) at one end only
Only one pontic with a rigid connector
Pontic is usually mesial to the retainer
(More posteriorly in the mouth, greater the occlusal force, increased risk of debonding)

Question 21

Describe a fixed movable bridge

Answer 21

Retainer at either end
Pontics lie between retainers
Rigid connector distally
Three or more units
Useful for non parallel retainers
Differentiating forces on bridge
Teeth not parallel
Curvature of arch
Allows some movement so less likely to debone

Question 22

What factors must be considered when prepping a tooth?

Answer 22

Thickness of bridge material
Alignment abutments
Path of insertion
Margin placement

Question 23

Why use a retraction cord?

Answer 23

Temporarily displace gingival margins to create accurate impressions of margins

Question 24

What considerations need to be made for a temporary bridge?

Answer 24

Aesthetics
Prevent tooth fracture
Prevent tooth sensitivity
Prevent overeruption or tooth movement (altered space of pontic)
Assess tooth prep
Gingival health - no gingivae growing over finish line

Question 25

Indications for fixed prosthesis

Answer 25

One or two adjacent teeth are missing in the same arch
Supportive tissues are healthy - strong and good root surface (post/core for RCT)
Pt in good health and wants prosthesis placed
Pt has skills and motivation to maintain good OH

Question 26

Contraindications for fixed pros

Answer 26

Necessary supporting tissues are diseased or missing
Suitable abutments not present
Pt in poor health
Pt not motivated to have prosthesis placed
Pt has poor OH
Pt cannot afford tx