Bridgework 1 Flashcards
why do we treat tooth loss?
- aesthetics
- function
- speech
- maintenance of dental health
what are tooth replacement options?
- Denture
- bridgework
- implants
what is a bridge?
prosthesis that replaces missing tooth and is attached to one or more natural teeth (can be implant retained too)
what are the main types of bridgework?
- Resin bonded (maryland)
- Conventional (1 tooth either side) [cantilever - 1 tooth abutment]
what are the general reasons we do bridgework?
- function & stability
- appearance
- speech
- psychological reasons
- systemic disease (epileptics cannot have loose stuff like dentures)
- cooperative patients with good OH
what are some contra-indications for bridgework?
- uncooperative pt
- Medical history contraindications
- poor OH
- high caries risk
- periodontal disease
- large pulps - conventional tooth prep may irritate pulp as tooth is prepared
what does abutment mean?
a tooth which serves as attachment for bridge
what does pontic mean?
artificial tooth which is suspended from the abutment teeth/tooth
what is a saddle area?
area of edentulous ridge over which a pontic(s) will lie
what is a retainer in bridgework?
A restoration connected to pontic & cemented to the prepared abutment teeth that helps provide retention
what are the types of bridge design?
- Conventional [fixed-fixed] bridge (1 retainer either side)
- Cantilever (1 retainer)
BOTH CAN BE ADHESIVE OR CONVENTIONAL (TOOTH PREP)
what are the advantages of adhesive/resin bonded bridgework?
- minimal/no prep/not destruction
- no LA needed
- cheap
- less chair time
- can be used as a provisional
what are the disadvantages of adhesive/resin bonded bridgework?
- clinical technique sensitive
- metal wing can shine through
- porcelain chips
- can debond (high chance on pressure loaded teeth)
- occlusal interferences
when would you do a resin bonded bridge?
- young teeth (less destructive)
- good enamel quality
- large abutment tooth surface area
- minimal occlusal load tooth
- good for single tooth replacement
- it can simplify RPD design
when would you NOT do a resin bonded bridge?
- insufficient/poor quality enamel
- long saddle areas
- heavy occlusal forces (or bruxist)
- poorly aligned, tilted, spaced teeth
- contact sports
what region in the mouth would you do a cantilever bridge design?
anterior teeth
what region in the mouth would you do a conventional/fixed-fixed design?
Posterior teeth
what is the thickness of a metal retainer wing used in bridgework?
0.7mm
what is the composition of the metal wing retainer?
Cobalt chrome or nickel-chromium alloy
what are the stages for cementation of a resin bonded bridge?
- Isolate with dam
- etch, wash & dry
- apply primer then dry
- fit retainer coated with CEMENT/LUTING agent
- remove excess
- Oxygen inhibitor placed around margins (if panavia 21 cement) to allow cement to set
what is Panavia 21?
It is an anaerobic curing adhesive cement that only cured when oxygen is excluded
after a crown has been cemented in, what should you do afterwards?
- check occlusion (make sure excessive occlusal forces applied onto pontic)
- demonstrate to pt how to clean around (superfloss & ID brushes)
