Bridgework 1

Question 1

why do we treat tooth loss?

Answer 1

• aesthetics
• function
• speech
• maintenance of dental health

Question 2

what are tooth replacement options?

Answer 2

• Denture
• bridgework
• implants

Question 3

what is a bridge?

Answer 3

prosthesis that replaces missing tooth and is attached to one or more natural teeth (can be implant retained too)

Question 4

what are the main types of bridgework?

Answer 4

• Resin bonded (maryland)
• Conventional (1 tooth either side) [cantilever - 1 tooth abutment]

Question 5

what are the general reasons we do bridgework?

Answer 5

• function & stability
• appearance
• speech
• psychological reasons
• systemic disease (epileptics cannot have loose stuff like dentures)
• cooperative patients with good OH

Question 6

what are some contra-indications for bridgework?

Answer 6

• uncooperative pt
• Medical history contraindications
• poor OH
• high caries risk
• periodontal disease
• large pulps - conventional tooth prep may irritate pulp as tooth is prepared

Question 7

what does abutment mean?

Answer 7

a tooth which serves as attachment for bridge

Question 8

what does pontic mean?

Answer 8

artificial tooth which is suspended from the abutment teeth/tooth

Question 9

what is a saddle area?

Answer 9

area of edentulous ridge over which a pontic(s) will lie

Question 10

what is a retainer in bridgework?

Answer 10

A restoration connected to pontic & cemented to the prepared abutment teeth that helps provide retention

Question 11

what are the types of bridge design?

Answer 11

• Conventional [fixed-fixed] bridge (1 retainer either side)
• Cantilever (1 retainer)

BOTH CAN BE ADHESIVE OR CONVENTIONAL (TOOTH PREP)

Question 12

what are the advantages of adhesive/resin bonded bridgework?

Answer 12

• minimal/no prep/not destruction
• no LA needed
• cheap
• less chair time
• can be used as a provisional

Question 13

what are the disadvantages of adhesive/resin bonded bridgework?

Answer 13

• clinical technique sensitive
• metal wing can shine through
• porcelain chips
• can debond (high chance on pressure loaded teeth)
• occlusal interferences

Question 14

when would you do a resin bonded bridge?

Answer 14

• 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

Question 15

when would you NOT do a resin bonded bridge?

Answer 15

• insufficient/poor quality enamel
• long saddle areas
• heavy occlusal forces (or bruxist)
• poorly aligned, tilted, spaced teeth
• contact sports

Question 16

what region in the mouth would you do a cantilever bridge design?

Answer 16

anterior teeth

Question 17

what region in the mouth would you do a conventional/fixed-fixed design?

Answer 17

Posterior teeth

Question 18

what is the thickness of a metal retainer wing used in bridgework?

Answer 18

0.7mm

Question 19

what is the composition of the metal wing retainer?

Answer 19

Cobalt chrome or nickel-chromium alloy

Question 20

what are the stages for cementation of a resin bonded bridge?

Answer 20

• 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

Question 21

what is Panavia 21?

Answer 21

It is an anaerobic curing adhesive cement that only cured when oxygen is excluded

Question 22

after a crown has been cemented in, what should you do afterwards?

Answer 22

• check occlusion (make sure excessive occlusal forces applied onto pontic)
• demonstrate to pt how to clean around (superfloss & ID brushes)