Bridges Flashcards
What is a bridge?
A fixed dental restoration that replaces one or more teeth
What are the 3 reasons for placing a bridge?
Aesthetics
Occlusion
Arch stability
What are the advantages of a RRB?
Minimal to no prep
Lower cost than implants or conventional bridge
Fixed option
What are the disadvantages of RRBs?
Debonding
Longevity
What are the indications of an RRB?
Good abutments
Favourable occlusion
Short span bridge (1 unit)
What are the advantages of a conventional bridge?
Fixed
Aesthetics
What are the disadvantages of a conventional bridge?
Tooth prep
More costly than a RRB
What are the indications for a conventional bridge?
Restored abutments
Adequate space
What are the contraindications for any bridge?
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
What are the advantages of removable denture?
Cheaper
Can replace large numbers of teeth
Non invasive
Easier cleaning
What are the disadvantages of dentures?
Bully
Patient tolerance
Aesthetics
What are the indications for dentures?
Replacing long spans of teeth
Provisional restorations
What are the contraindications?
Patient tolerance
What are the advantages of an implant?
Does not damage adjacent teeth
Aesthetic
Gold standard for replacing a single tooth
What are the disadvantages of implants?
Costly
Requires surgery
What are the indications for implants?
Congenitally missing teeth
Divergent abutments
Good bone levels
What are the contraindications for implants?
Inadequate bone
Patients MH
Anatomy - close to floor of sinus
What materials can bridges be made from?
Metal
Ceramic
PFMs
Describe a fixed-fixed bridge
Retainer at either end
Pontics lie between retainers
Rigid connector joins pontic to retainer
Describe a cantilever bridge
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)
Describe a fixed movable bridge
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
What factors must be considered when prepping a tooth?
Thickness of bridge material
Alignment abutments
Path of insertion
Margin placement
Why use a retraction cord?
Temporarily displace gingival margins to create accurate impressions of margins
What considerations need to be made for a temporary bridge?
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
Indications for fixed prosthesis
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
Contraindications for fixed pros
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
