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BDS4 Restorative Dentistry > Bridgework 1 > Flashcards

Bridgework 1 Flashcards

1
Q

tx options for missing tooth / teeth

A
  1. no tx i.e. leave space
  2. replace tooth / teeth
  3. close space i.e. ortho
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2
Q

4 reasons for tx of tooth loss

A
  1. aesthetics
  2. function
  3. speech
  4. maintenance of oral health
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3
Q

3 options for tooth replacement

A
  1. denture
  2. bridgework
  3. implants
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4
Q

what is a bridge

A

a prothesis which replaces a missing tooth or teeth and is attached to 1 or more natural teeth (or implants)
basically a fixed partial denture

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5
Q

2 main types of bridgework

A
  1. adhesive - held on with ‘wings’ that go on palatal surfaces of abutment teeth
  2. conventional - held on with crowns on abutment teeth
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6
Q

general indications for bridgework

A
  • function & stability
  • appearance
  • speech
  • psychological reasons
  • systemic disease e.g. epileptics
  • cooperative pt
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7
Q

local indications for bridgework

A
  • big teeth
  • heavily restored teeth
  • favourable abutment angulations
  • favourable occlusion
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8
Q

general contraindications for bridgework

A
  • uncooperative pt
  • medical hx
  • poor OH
  • high caries rate
  • periodontal disease
  • large pulps (more in conventional bridge)
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9
Q

local contraindications for bridgework

A
  • high possibility of further tooth loss within arch
  • prognosis of abutments poor
  • length of span too great
  • ridge form & tissue loss
  • tilting & rotation of teeth
  • degree of restoration i.e. how much tooth left after prep
  • periapical status
  • periodontal status
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10
Q

pontic

A

artificial tooth which is suspended from the abutment teeth / tooth

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11
Q

retainers

A

extra / intracoronal restorations that are connected to the pontic & cemented to the prepared abutment teeth

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12
Q

connectors

A

component which connects the pontic to the retainers / retainer

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13
Q

pier

A

an abutment tooth which stands between and is supporting 2 pontics, each pontic being attached to a further abutment tooth

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14
Q

conventional bridge

A

retainer = crown
can have fixed fixed, fixed cantilever, fixed moveable

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15
Q

adhesive bridge

A

retainer = metal (NiCr or CoCr)
minimal or no prep
wing of metal comes off the side of the pontic and is attached to palatal surface of abutment tooth

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16
Q

cantilever

A

bridge has a retainer on only 1 side of the pontic
retainer can be a conventional crown retainer or an adhesive / resin retained metal wing

17
Q

fixed fixed

A

retainers on both sides of pontic that are joined by rigid connectors
retainers tend to be crowns which are all ceramic or MCC
mostly posterior teeth

18
Q

+ of conventional fixed fixed bridge

A
  • robust design
  • maximum retention & strength
  • abutment teeth splinted together
  • can be used in longer spans
  • lab construction straightforwards
19
Q
  • of conventional fixed fixed bridge
A
  • prep difficult (parallel tooth prep needed)
  • prep must be minimally tapered (5-7 degrees)
  • common path of insertion for both abutments
  • removal of tooth tissue (danger to pulp)
20
Q

+ of conventional cantilever bridge

A
  • conservative design compared to fixed fixed conventional design
  • lab construction straightforward
  • no need to ensure multiple tooth preps are parallel
21
Q
  • of conventional cantilever bridge
A
  • short span only
  • rigid to avoid distortion
  • mesial cantilever preferred
22
Q

why is a mesial cantilever preferred

A

in this case the retainer is the more posterior tooth and the pontic is further anterior
this is because when the pt occludes they are more likely to make contact with their posterior teeth first

23
Q

fixed moveable bridge

A

has a rigid connector usually at the distal end of the pontic & a moveable connector mesially
allows some vertical movement at the mesial abutment tooth

24
Q

+ of conventional fixed moveable bridge

A
  • prep doesn’t require a common path of insertion
  • each prep designed to be retentive independent of others
  • more conservative of tooth tissue
  • allows minor tooth movement
  • may be cemented in 2 parts
25
Q
  • of conventional fixed moveable bridge
A
  • length of span limited i.e. only want to be replacing 1 tooth with this type of bridge due to increase in flexibility & tooth movement
  • lab construction more complex
  • possible difficulty in cleaning between moveable joint
  • can’t construct provisional bridge
26
Q

hybrid bridge

A

one retainer is conventional prep and the other is minimal prep i.e. adhesive . resin retained or bonded
metal wing likely to debond and go unnoticed due to stability on conventional prep
rarely seen

27
Q

spring cantilever

A

one pontic attached to end of metal arm that runs across palate to a rigid connector on palatal side of retainer

28
Q

+ of conventional spring cantilever

A
  • useful if spacing present between upper incisors
  • where adjacent teeth are unrestored
  • where a posterior tooth would provide suitable abutment i.e. already has a crown / large direct rest
29
Q
  • of conventional spring cantilever bridge
A
  • can only be used to replace upper incisor teeth
  • difficult to clean beneath palatal connector
  • may irritate palatal mucosa
  • difficult to control movement of pontic due to springiness of metal arm & displacement of palatal soft tissues
30
Q

abutment evaluation

A
  • must be able to withstand forces previously directed to missing teeth
  • supporting tissues should be healthy & free of inflammation
  • crown : root ratio; length of tooth coronal to alveolar crest compared to length of root embedded in bone. optimum ratio 2:3 & minimum is 1:1
31
Q
A

BDS4 Restorative Dentistry (8 decks)

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