Bridgework Flashcards
What is a bridge
A prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth
What are general indications for bridgework
Function and stability
Apperance
Speech
Psychological reasons
systemic disease
What are local indications for bridgework
Big teeth
Heavily restored teeth
Favorable abutment angulations
Favorable occlusion
Contraindications for bridgework
Uncooperative patient
Medical history contra-indications
Poor oral hygiene
High caries rate
Periodontal disease
Large pulps
High possibility of further tooth loss within arch
Prognosis of abutment poor
Length of span too great
Ridge form and tissue loss
Tilting and rotation of teeth
Degree of restoration
Periapical status and perio
What is meant by abutment
a tooth that serves as am attachement for a bridge
What is meant by pontic
Artificial tooth which is suspended from abutment tooth
What is meant by retainer in bridgework
The extracoronal or intracoronal restorations that are connected to the pontic and cemented to the prepared abutment teeth
What is meant by coonectors
Component which connects the pontic to the retainer
What is meant by Edentolous span
Space between teeth that is to be filled by a bridge or partial denture
What is meant by saddle
Area of the edentolous ridge over which the pontic lies
What is meant by pier
An abutment tooth which stands between and is supporting 2 pontics, with each pontic attached to a further abutment tooth
What is meant by unit
Either a retaineer or pontic
What is a fixed fixed bridge
A pontic with a retainer each end
What is a cantilever bridge
Bridge with a retainer at 1 side of the pontic
What is resin bonded bridgework (RBB) also known as
Adhesive bridgework
Min. prep. bridgework
Maryland bridge
What are the adv of RBB
Minimal or no preparation
No anaesthetic needed
Less costly
Less surgery time
Can be used as a provisional restoration
If fails - usually less destructive than alternatives
What are the dis-Adv of RBB
Rigorous clinical technique
Metal shine-through
Chipping pocelain
Can debond
High chance of it debonding again
Occlusal interferences
No trial period possible
What are the indications for RBB
Young teeth (Less destructive)
Good enamel quality
Large abutment tooth surface area
Minimal occlusal load
Good for single tooth replacement
Simplify partial denture design
When would you not use RBB
Insufficent/poor quality enamel
long spans
Excess soft or hard tissue loss
Heavy occlusal force (bruxism)
Poorly aligned, tilted or spaced teeth
When planning bridges what would you mount it on
semi adjustable articulator
Whats important to check for Tx planning bridges
Dynamic occlusal relationships
-clinically
-mounted study models
-Consider wax ups
What are the 2 forms of RBB
Direct and Indirect
When are direct RBB best for
emergency situations
Whats happens in direct RBB
make a pontic
-Ideally patients own tooth
-Polycarbonate crown
- Cellulose matrix filled with composite
What is needed for indirect RBB
Generous palatal/lingual coverage
good quality enamel
keep supra gingival, 0.5mm
What is the best design for Ant. bridges
Cantilever
What is the best design for post. bridges
Fixed Fixed
Why cantilever bridges ant.
Divergent guidance paths
If required what is the prep for RBB
180 ‘wrap around’ prep
Rest seats
supra gingival chamfer finish line 0.5mm
remain in enamel
What does sandblasting do
micro-mechanical retention
50microns
When Tx planning a bridge what is the occlusal info you want
Incisal classification
Canine-guided or group function
Opposing tooth over-erupted
Will bridge interfere with current occlusion
Signs of parafunction present
What do you evaluate of potential abutments
Root configuration
Angulation/rotation of abutment
Periodontal health
Surface area for bonding & quality of enamel
Risk of pulpal damage
Quality of endodontics:
Re-root canal treatment
Remaining tooth structure present
What are the considerations in pontic design
Cleanseability
Apperance
Strength
What are the different pontic designs
- wash through
- dome
- modified ridge lap
- Ridge lap
- Ovate
What is the wash through pontic design
Makes no contact with soft tissue
Functional rather than for appearance
Consider in lower molar area
What is the dome shaped pontic design
Useful in lower incisor, premolar or upper molar areas
Acceptable if occlusal 2/3 of buccal surface visible
What is modified ridge lap pontic design
Buccal surface looks as much like tooth as possible
Lingual surface cut away
Line contact with buccal of ridge
Problems with food packing on lingual surface of ridge
What is ridge lap pontic design
Greatest contact with soft tissue
If designed carefully: can be cleansed
Less food packing than ridge-lap
Care taken not to displace soft tissue or cause blanching of tissue
What materials are used for conventional bridges
All metal
Metal ceramic
All ceramic
Ceromeric
When would gold be used
Lower post. area
What should you try to avoid and why
distal cantilevers
Concern that occlusal forces on pontic will produce leverage forces on abutment tooth causing it to tilt
What cement is used for all metal conventional bridgework and metal ceramic
Aquacem (GI luting cement)
RelyX luting (RMGI luting cement)
What cement is used for Adhesive bridge
panavia 21 (anerobic duel cure resin cement)
What cement is used for a all ceramic bridge
NEXUS (duel cure resin cement)
