BRIDGEWORK 1

Question 1

what are some reasons for treating tooth loss?

Answer 1

• aesthetics
• function
• speech
• maintenance of dental health

Question 2

What are some tooth replacement options?

Answer 2

• denture
• bridgework
• implants

Question 3

What is a bridge?

Answer 3

A prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth

Question 4

What are the two types of bridgework?

Answer 4

• adhesive
• “conventional”

Question 5

If a patient was needing to replace soft tissue and bone as well as teeth, what would be suitable?

Answer 5

RPD more suitable (bridge does not really replace soft tissue)

Question 6

What would be indications for bridgework?

Answer 6

• function and stability needed
• improve appearance
• speech
• psychological reasons
• systemic disease (EPILEPTICS!)
• co-operative patient

Question 7

What is a suitable option for replacing teeth in epileptic patients?

Answer 7

fixed prosthetics (RPD not suitable as it can become dislodged)

Question 8

What are some local indications for bridgework?

Answer 8

• big teeth
• heavily restored teeth
• favourable abutment angulations
• favourable occlusion

Question 9

What are some general contra-indications for bridgework?

Answer 9

• uncooperative patient
• medical history
• poor OH
• high caries rate
• periodontal disease
• large pulps (conventional bridge)

Question 10

What are some localcontra-indications for bridgework?

Answer 10

• 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

Question 11

What is the meaning of “abutment” in reference to bridgework?

Answer 11

• a tooth which serves as an attachment for a bridge

Question 12

What is the meaning of “pontic” in reference to bridgework?

Answer 12

the artificial tooth which is suspended from the abutment teeth/tooth

Question 13

What is the meaning of “retainers” in reference to bridgework?

Answer 13

the extracoronal or intracoronal restorations that are connected to the pontic and cemented to the prepared abutment teeth

Question 14

What is the meaning of “connector” in reference to bridgework?

Answer 14

component which connects the pontic to the retainers/retainer

Question 15

What is the meaning of “edentulous span” in reference to bridgework?

Answer 15

space between natural teeth that is to be filled by a bridge or partial denture

Question 16

What is the meaning of “saddle” in reference to bridgework?

Answer 16

area of edentulous ridge over which the pontic will lie

Question 17

What is the meaning of “pier” in reference to bridgework?

Answer 17

An abutment tooth which stands between and is suppoting two pontics, each pontic being attached to a further abutment tooth

Question 18

What is the meaning of “unit” in reference to bridgework?

Answer 18

either a retainer or pontic

Question 19

What is a fixed-fixed bridge?

Answer 19

• this type of bridge has a retainer at each end with a pontic in the middle joined by rigid connectors

Question 20

What is a cantilever bridge?

Answer 20

this type of bridge has a retainer at one side of the pontic only

Question 21

What are the advantages of conventional fixed-fixed bridges?

Answer 21

• robust designs
• maximum retention and strength
• abutment teeth splinted together
• can be used in longer spans
• lab construction is straightforward

Question 22

What are the disadvantages of conventional fixed-fixed bridges?

Answer 22

• preparation difficult
• preparation must be minimally tapered
• common path of insertion for abutments
• removal of tooth tissue

Question 23

What are the advantages of resin bonded bridgework?

Answer 23

• 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

Question 24

What are the disadvantages of resin bonded bridgework?

Answer 24

• rigorous clinical technique (must be super dry as cemented with composite)
• metal shine-through
• chipping porcelain
• can debond
• occlusal interferences
• no trial period possible

Question 25

What are the indications for resin bonded bridework?

Answer 25

• young teeth
• good enamel quality
• large abutment tooth surface area
• minimal occlusal load
• good for single tooth replacement
• simplify RPD design

Question 26

What are the contraindications for resin bonded bridework?

Answer 26

• 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)

Question 27

What is involved in the treatment planning for resin bonded bridges?

Answer 27

• history
• examination (check dynamic occlusal relationships, periodontal status, radiology)
• study models

Question 28

How should study models for resin bonded bridgework be mounted?

Answer 28

semi-adjustable articulator with facebow registration

Question 29

When do you use cantilever or fixed-fixed design bridge?

Answer 29

Anterior
- (generally) cantilever design

Posterior
- (generally) fixed-fixed design

Question 30

Why are cantilevers more successful anteriorly?

Answer 30

divergent guidance paths anteriorly (all long axis of teeth differ, so occlusal loads and forces go different directions)

Question 31

If preparation is required for resin bonded bridges, what is involved?

Answer 31

• 180 degrees ‘wrap around’ prep
• rest seats and cingulum rests occasionally
• occasionally place proximal grooves
• supra gingival chamfer line 0.5mm above

Question 32

If anterior preparation is required for resin bonded bridges, what is involved?

Answer 32

MINIMAL PREP
- occlusal contact reduction
- cingulum undercut removal only
- chamfer margin (0.5mm supra-gingival)