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FRP - Crowns/Bridges/Wear/TMD/SDA/IMPLANTS > Bridges > Flashcards

Bridges Flashcards

1
Q

tooth replacement options

A

bridge
implant
RPD

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2
Q

indication for bridgework

A 
Function and stability
Appearance
Speech
Psychological reasons
Systemic disease e.g. epileptics
Co-operative patient
Big teeth
Heavily restored teeth
Favourable abutment angulations
Favourable occlusion
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3
Q

contraind of bridgework

A 
Uncooperative patient
Medical history contra-indications
Poor oral hygiene
High caries rate
Periodontal disease
Large pulps
High possibility of further tooth loss within arch
Prognosis of abutment poor
Length of span too great
Ridge form and tissue loss
Surface area of root insufficient
tilting/rotation of teeth
poor periodontal condition
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4
Q

name some type of bridge designs

A 
Fixed-fixed bridge
Cantilever bridge
•Conventional (Fixed)
•Adhesive/resin retained
Fixed-moveable bridge
Hybrid bridge
•Fixed retainer and adhesive retainer
Spring cantilever bridge
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5
Q

ADV of fixed-fixed design

A 
Robust design
Maximum retention and strength
Abutment teeth splinted together ? (Perio)
Can be used in a long span
Laboratory construction straightforward
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6
Q

DIS of fixed-fixed design

A
  • Need parallel prep
  • Extensive tooth destruction
  • Need minimal taper
  • common POI needed
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7
Q

ADV of conventional cantilever

A

Conservative design
•Compared to fixed-fixed conventional design
Laboratory construction straightforward
No need to ensure preparations are parallel

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8
Q

DIS of conventional cantilever

A

Short span only
Rigid to avoid distortion
Mesialcantilever preferred?

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9
Q

important aspects of abutment evaluation

A

Must be able to withstand the forces previously directed to the missing teeth
Supporting tissues should be healthy and free of inflammation
•i.e.periapical disease and periodontal disease
Crown to root ratio
•length of tooth coronal to alveolar crest compared to length of root embedded in bone. Optimum ratio 2:3.
oMinimum ratio 1:1
Root configuration
Root surface area (periodontal ligament area)

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10
Q

what is ante’s law

A

States that the root surface area of the abutment teeth should be equal or greater than that of the teeth being replaced with pontics.

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11
Q

ADV of Adhesive bridge

A

Minimal or no preparation
No anaesthetic needed
Less costly
Less surgery time
Can be used as a provisional restoration
If fails -usually less destructive than alternatives

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12
Q

DIS of Adhesive bridge

A 
Uncertain longevity
Rigorous clinical technique
Metal shine-through
Can debond
•High chance of it debonding again
Occlusal interferences
No trial period possible
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13
Q

indication of adhesive bridgework

A 
Young teeth
Less destructive
Good enamel quality
Large abutment tooth surface area
Minimal occlusal load
Good for single tooth replacement
Simplify partial denture design
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14
Q

contraind of Adhesive bridgework

A 
Insufficient or poor quality enamel
Long spans
Excess soft or hard tissue loss
Heavy occlusal force e.g. Bruxist
Badly aligned, tilted or spaced teeth
Contact sports?
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15
Q

Treatment planning for bridgework

A 
History
•Establish habits e.g. Bruxism
Examination
•Clinical
oDynamic occlusal relationships
•Periodontal
•Radiological
Study models
•Mounted on semi-adjustable articulator with
facebowregistration
•Consider diagnostic wax-ups
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16
Q

RRB - direct vs Indirect

A 
Direct
•Very useful in emergency situation
•If tooth needs to be extracted immediately
•If tooth has been lost traumatically
Indirect
•No preparation
•Minimal preparation
•Heavy preparation (Undesirable
17
Q

what happens to CoCr in order to make it more retentive

A

sandblasted with Aluminium oxide 50 microns

18
Q

anterior prep for cantilever

A 
180º ‘wrap-around’ preparation
Rests
•Rest seats (posterior teeth)
•Cingulum rest (anterior teeth)
Proximal grooves
Supra-gingival chamfer finish line ~0.5mm
Ideally prep should remain in enamel
Cantilever design
Chamfer preparation
0.5mm supra-gingival
Cingulum rest
Proximal grooves
19
Q

Posterior prep - cantilever

A 
Occlusal rests
180º wrap-around with chamfer finish line
0.5mm supra-gingival
Proximal grooves
Can be cantilever or fixed-fixed design
20
Q

longevity

  • cantilever
  • fixed-fixed
A 
27.88%failure rate 1-16 yrs
•Djemal S et al.(1999)
Overall survival after 4 years –79.6%
Cantilever bridges had greater survival than other bridge designs
Cantilever median survival: 9.8 yrs
Fixed-fixed median survival: 7.8 yrs
21
Q

Information for bridge prep

A 
History
•Presenting complaint
•Medical and social history
•Past dental history
Clinical examination (Extra-and intra-oral)
•Soft tissues
•Periodontal
•Caries risk assessment
•Occlusion
•Parafunction
Abutment evaluation
•Remaining tooth structure
•Special tests
oRadiographs
22
Q

Abutment evaluation information

A 
Root surface area and Crown-root ratio
•Ante’s Law
Root configuration
Angulation/rotation of abutment
Periodontal health
Surface area for bonding & quality of enamel
Risk of pulpal damage
Quality of endodontics:
•Re-root canal treatment?
Remaining tooth structure present?
Core
•Remove and rebuild?
Post & core
•Remove and replace?
23
Q

consideration for pontic design

A

Cleansability
•Should always be smooth, with highly polished or glazed surface
•Surface should not harbour join of metal and porcelain
•Embrasure space smooth and cleansable
Appearance
•Anteriorly:
oAs ‘tooth like’ as possible
•Posteriorly:
oMay compromise
Strength
•Longer the span -Greater the thickness required to withstand occlusal forces

24
Q

wash through pontic design, considerations

A

Wash-through: (Hygienic or Sanitary)
•Makes no contact with soft tissue
oFunctional rather than for appearance
oConsider in lower molar area

25
Q

types of pontic design

A

wash through
dome shaped
modified ridge lap
ridge lap/saddle

26
Q

dome shaped design considerations

A

Dome-shaped: (Torpedo or Bullet-Shaped)
•Useful in lower incisor, premolar or upper molar areas
•Acceptable if occlusal 2/3 of buccal surface visable
oPoor aestheitcs if gingival 1/3 of tooth visable

27
Q

modified ridge lap considerations

A

Modified ridge lap:
Buccal surface looks as much like tooth as possible
Lingual surface cut away
Line contact with buccal of ridge
Problems with food packing on lingual surface of ridge

28
Q

ridge lap/saddle design considerations

A 
Ridge lap/Saddle:
Greatest contact with soft tissue
If designed carefully: can be cleansed
Less food packing than ridge-lap
Care taken not to displace soft tissue or cause blanching of tissue
29
Q

preparation stages for a bridge

A
  1. mounted study models/diagnostic wax up
  2. Select shade
    Laboratory made stent or make pre-operative putty impression for provisional bridge
    Occlusal or incisal reduction
    Separation of teeth
    Aim for parallelismof tapered surface of each preparation
    •Example: Preparation of fixed-fixed bridge for 13 1211
    oPrep mesial of 11, then mesial of 13
    oPrep distal of 11, then distal of 13
    oPrep labial (2-planes) of 11, then labial 13 …..etc
  3. Confirm parallelism
    Consider retentive features if short clinical crown height or overtapered
    •Slots or
    •Grooves
    Construct provisional bridge
    Make impression and occlusal registration
    Temporarily cement provisional bridge
    Demonstrate cleaning with Superfloss™
    Write/draw prescription for technician
30
Q

importance of parallelism

A

Consider for fixed-fixedconventional bridge
•Requires two or more teeth to be prepared in a manner to provide a common path of insertion
•No undercuts but to give retentive preparations
Paralleling by eye
•Direct vision, one-eye closed
•Large mouth mirror (posteriorly)
•Use of a straight (right angle) probe like a laboratory surveyor, but in the mouth
Extra-oral survey
•Quick impression
•Pour a model
•Use a laboratory surveyor; useful in long span multiple unit bridges

FRP - Crowns/Bridges/Wear/TMD/SDA/IMPLANTS (8 decks)

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