BRIDGEWORK 1 Flashcards
what are some reasons for treating tooth loss?
- aesthetics
- function
- speech
- maintenance of dental health
What are some tooth replacement options?
- denture
- bridgework
- implants
What is a bridge?
A prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth
What are the two types of bridgework?
- adhesive
- “conventional”
If a patient was needing to replace soft tissue and bone as well as teeth, what would be suitable?
RPD more suitable (bridge does not really replace soft tissue)
What would be indications for bridgework?
- function and stability needed
- improve appearance
- speech
- psychological reasons
- systemic disease (EPILEPTICS!)
- co-operative patient
What is a suitable option for replacing teeth in epileptic patients?
fixed prosthetics (RPD not suitable as it can become dislodged)
What are some local indications for bridgework?
- big teeth
- heavily restored teeth
- favourable abutment angulations
- favourable occlusion
What are some general contra-indications for bridgework?
- uncooperative patient
- medical history
- poor OH
- high caries rate
- periodontal disease
- large pulps (conventional bridge)
What are some localcontra-indications for bridgework?
- high possibility of further tooth loss within arch
- poor prognosis of abutment teeth
- length of span too great
- ridge form and tissue loss
- tilting and rotation of teeth
- degree of restoration
- periapical status
- periodontal status
What is the meaning of “abutment” in reference to bridgework?
- a tooth which serves as an attachment for a bridge
What is the meaning of “pontic” in reference to bridgework?
the artificial tooth which is suspended from the abutment teeth/tooth
What is the meaning of “retainers” in reference to bridgework?
the extracoronal or intracoronal restorations that are connected to the pontic and cemented to the prepared abutment teeth
What is the meaning of “connector” in reference to bridgework?
component which connects the pontic to the retainers/retainer
What is the meaning of “edentulous span” in reference to bridgework?
space between natural teeth that is to be filled by a bridge or partial denture
What is the meaning of “saddle” in reference to bridgework?
area of edentulous ridge over which the pontic will lie
What is the meaning of “pier” in reference to bridgework?
An abutment tooth which stands between and is suppoting two pontics, each pontic being attached to a further abutment tooth
What is the meaning of “unit” in reference to bridgework?
either a retainer or pontic
What is a fixed-fixed bridge?
- this type of bridge has a retainer at each end with a pontic in the middle joined by rigid connectors
What is a cantilever bridge?
this type of bridge has a retainer at one side of the pontic only
What are the advantages of conventional fixed-fixed bridges?
- robust designs
- maximum retention and strength
- abutment teeth splinted together
- can be used in longer spans
- lab construction is straightforward
What are the disadvantages of conventional fixed-fixed bridges?
- preparation difficult
- preparation must be minimally tapered
- common path of insertion for abutments
- removal of tooth tissue
What are the advantages of resin bonded bridgework?
- minimal or no preparation required
- no anaesthetic needed
- less costly
- less surgery time
- can be used as provisional restoration
- less destructive if fails than alternatives
What are the disadvantages of resin bonded bridgework?
- rigorous clinical technique (must be super dry as cemented with composite)
- metal shine-through
- chipping porcelain
- can debond
- occlusal interferences
- no trial period possible
What are the indications for resin bonded bridework?
- young teeth
- good enamel quality
- large abutment tooth surface area
- minimal occlusal load
- good for single tooth replacement
- simplify RPD design
What are the contraindications for resin bonded bridework?
- insufficient or poor quality enamel
- long spans
- excess soft or hard tissue loss
- heavy occlusal force (bruxism)
- poorly aligned, tilted or spaced teeth
- contact sports?? (debatable)
What is involved in the treatment planning for resin bonded bridges?
- history
- examination (check dynamic occlusal relationships, periodontal status, radiology)
- study models
How should study models for resin bonded bridgework be mounted?
semi-adjustable articulator with facebow registration
When do you use cantilever or fixed-fixed design bridge?
Anterior
- (generally) cantilever design
Posterior
- (generally) fixed-fixed design
Why are cantilevers more successful anteriorly?
divergent guidance paths anteriorly (all long axis of teeth differ, so occlusal loads and forces go different directions)
If preparation is required for resin bonded bridges, what is involved?
- 180 degrees ‘wrap around’ prep
- rest seats and cingulum rests occasionally
- occasionally place proximal grooves
- supra gingival chamfer line 0.5mm above
If anterior preparation is required for resin bonded bridges, what is involved?
MINIMAL PREP
- occlusal contact reduction
- cingulum undercut removal only
- chamfer margin (0.5mm supra-gingival)
