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BDS4 Exam Perp > Bridgework > Flashcards

Bridgework Flashcards

1
Q

What are the 3 broad treatment options for a missing tooth?

A
  • no treatment
  • Replace tooth
  • Close space (orthodontics)
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2
Q

4 reasons for treating tooth loss

A
  • Aesthetics
  • Function
  • Speech
  • Maintain dental health
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3
Q

3 ways to replace teeth?

A
  • Denture
  • Bridgework
  • Implants
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4
Q

What is a bridge?

A

A prosthesis which replaces missing tooth or teeth that is attached to one or more natural teeth (or implants)

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5
Q

What are the 2 types of bridgework?

A
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6
Q

What are 6 general indications for bridgework?

A
  • Function and stability
  • Appearance
  • Speech
  • Psychological reasons
  • Systemic disease
  • Co-operative patient
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7
Q

What systemic disease might be an indication for replacing missing teeth by a bridge?

A
  • Epilepsy
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8
Q

What are 4 local indications for bridgework?

A
  • Big teeth
  • heavily restored teeth
  • Favourable abutment angulations
  • Favourable occlusion
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9
Q

What are 7 general contraindications for bridgework?

A
  • uncooperative patient
  • Medical history contrainfdications
  • Poor oral hygiene
  • High caries rate
  • Periodontal disease
  • Large pulps for conventional bridge
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10
Q

What are 8 local contraindications for bridgework?

A
  • High possibility of tooth loss within arch
  • Poor prognosis of abutment teeth
  • Long spans
  • Ridge form and tissue loss
  • Tilting and rotation of teeth
  • Degree of restoration
  • PA status
  • Periodontal status (bone loss)
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11
Q

What is an abutment?

A

tooth serves as an attachment for a bridge

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12
Q

What is a pontic?

A

Artificial tooth which is suspended from the abutment/s

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13
Q

What is a retainer?

A

The extracoronal or intracoronal restorations that is connected to the Pontic and cemented to the prepared abutement tooth

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14
Q

What is connectors in bridgework?

A

Component that connect the pontic to the retainer

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15
Q

What is the edentulous span?

A
  • Space between natural teeth to be replaced
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16
Q

What is a saddle?

A

Area of edentulous ridge where the pontic will sit

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17
Q

What is pier?

A

An abutement tooth which is supporting two pontics

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18
Q

What is Unit?

A

Either a pontic or a retainer

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19
Q

What are the two types of bridge designs?

A
  • Fixed-Fixed : R-P-R
  • Cantilever : R-P
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20
Q

What two materials can retainers be in adhesive bridges?

A
  • Ceramic
  • Metal : CoCr, NiCR
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21
Q

What are 6 advantages of adhesive cantilever bridges?

A
  • Minimal or no preparation
  • No LA
  • better cost
  • less surgery time
  • Can be used as provisional restoration
  • Less destructive if it fails
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22
Q

What are 6 disadvantages of Cantilever adhesive bridges?

A
  • Advanced clinical technique
  • Metal can shine through
  • Chipping of porcelain
  • Can debond
  • Occlusal interference
  • No trial period possible
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23
Q

What are 6 indications of adhesive cantilever?

A
  • young teeth
  • good enamel quality
  • large surface area of abutment tooth
  • minimal occlusal load
  • single tooth replacement
  • simplify partial denture design
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24
Q

What are 6 contraindications for adhesive cantilever bridge?

A
  • Poor quality of enamel
  • long spans
  • Contact sports
  • bruxism
  • Soft or hard tissue loss
  • tilted or spaced teeth
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25
What part of the history is important when making an adhesive cantilever bridge?
Parafunctional habits : bruxism
26
What part of the denal history is important when assessing a patient suitability for adhesive cantilever bridge work other than parafunctional habits:?
Oral hygiene
27
What Special investigations would you carry out when making an adhesive cantilever bridge?
* Mounted study casts * Radiographs ( Pa, OPT?)
28
3 indications of direct resin bonded bridge?
* very useful in emergency situations * if tooth needs to be extracted immediately * traumatic tooth loss
29
Patient comes to you as emergency , his tooth was fractured at the cervical margin, and you decide to make a direct adhesive cantilever bridge to replace the space, what will you use as a pontic?
Patient own tooth
30
Patient comes to you as emergency , his tooth was fractured at the cervical margin, and you decide to make a direct adhesive cantilever bridge to replace the space, How will you do that with the patient own tooth?
* Acid etch patient tooth and abutement teeth at the contact points * Use composite to support the tooth between the two abutments
31
What other alternatives other than the patient tooth as a pontic for direct bridgework?
* Acrylic denture tooth * Polycarbonate crown * Cellulose matrix filled with composite
32
How much space do you need supragingivally on an abutment tooth for an indirect resin bonded bridge?
0.5mm
33
What factors of an abutement tooth indicates better bond in indirect resin bonded bridge?
* Large lingual/palatal surface area of enamel on abutement
34
Why should you avoid coverage of indirect RRB near incisal edges?
* Because enamel is translucent in that area and metal can shine through
35
What bridge design is ideal for anteriors?
* Cantilever
36
What bridge design is ideal for posterior teeth?
fixed-fixed
37
Why cantilevers are more successful anteriorly?
Due to divergent guidance paths of anterior teeth , making a fixed fixed design more likely to debond
38
Why should amalgam be replaced on an abutment tooth when placing an RBB bridge ?
Poor bond to chemically cured composite cement
39
4 characteristics of preparing abutment tooth for RRB if required?
* 180 wrap around preparations * Rests ( seats for posterior , cingulum anteriors( * 0.5mm chamfer finish supra gingivally * Preparation should remain in enamel
40
What are 3 steps in minimally preparing an anterior abutment for RRB?
* Occlusal contact reduction * Cingulum undercut removal * 0.5mm supra-gingival chamfer margin
41
What are 3 steps for a heavy RRB preparation in an anterior abutement tooth?
* 0.5 mm palatal/ lingual reduction * Cingulum rest * 0.5mm supragingival chamfer margin * can add proximal grooves
42
What is the minimum thickness of the metal in RRB?
0.7mm
43
How to prepare a posterior tooth for bridgework?
* 180 wrap around * Occlusal rests * 0.5 supragingival chamfer finish * can add proximal groove
44
How to manage a tooth if the preparation goes into dentine?
* cover with DBA if tooth becomes sensitive
45
2 reasons why you should fit the bridge as quickly as possible?
* minimise overeruption * minimise tooth movement
46
What can you use for temporising a bridge?
Consider RPD
47
How can you increase the bond of an RRB retainer ?
Sandblast with aluminum oxide (50 microns)
48
What type of bond is created with a sandblasted RRB retainer?
Micro-mechanical bond
49
How would you clean the retainer after trying it in if it has been contaminated with unset composite?
* Ultrasonic bath * Ethanol to degrease
50
What is the function of degreasing the tooth by ethanol if contaminated?
Reduce surface tension
51
What cement would you use to cement a resin bonded bridge?
* Chemically or dual cure composite luting cement
52
What would you place around cement margins when cementing a bridge?
Oxyguard II gel for 3 minutes
53
What is oxyguard gel?
Oxygen inhibitor
54
What should you check after cementing a bridge?
* Check occlusion - ensure no high occlusal load on pontic * Demonstrate how to clean around and underneath bridge
55
What would you advice the patient to use for cleaning around and underneath the bridge (2)?
* Superfloss * Interdental brushes
56
What are the survival rate of RRB in 5 and 10 years?
5 - 80.8% 10 - 80.4%
57
Give 5 examples of bridge designs with conventional component?
* Fixed-Fixed * Fixed-cantilever * Hybrid bridge * Fixed-moveable * Spring cantilever
58
What are 5 advantages of conventional fixed-fixed bridges?
* Robust design * Maximum retention and strength * Abutement teeth splinted together - good in mobile teeth * Can be used for longer spans * Easy lab construction
59
4 disadvantages of conventional fixed-fixed bridges?
* difficult preparation ( parallel tooth prep) * Preparation must be minimally tapered * Removal tooth tissue (pulp damage?) * Common path of insertion needed for abutements
60
What are 3 advantages of conventional cantilever bridge?
* Conservative * Easy laboratory construction * No need for parallel tooth preparations
61
What are 3 disadvantages of conventional cantilever
* Used for short span only * Rigid (to avoid distortion) * Mesial cantilever is preferred
62
What bridge design may be an alternative for conventional fixed-fixed design when parallel tooth preparation is not possible due to different path of insertion of one abutement ?
* Fixed-moveable bridge * Have a dovetail on bridge and slot on abutment
63
Describe a fixed moveable bridge?
rigid connector on the distal of pontic and a moveable connector at the mesial to allow some vertical movement on the mesial end
64
What are 5 advantages of fixed moveable bridges?
* Preparations do not require common path of insertion * Each preparation is retentive independently * More conservative to tooth tissue * Allow minor tooth movement * Can be cemented in two parts
65
What are 4 disadvantages of fixed moveable bridge?
* Limited length of span * Complicated laboratory construction * Difficulty cleaning beneath moveable joint * No provisional bridge
66
What is a hybrid bridge?
A bridge with one conventional retainer and other minimal preparation retainer (adhesive)
67
What is a spring cantilever bridge?
One pontic that is attached to a metal arm that runs across the palate to a rigid connector on the palatal side of the retainer
68
What are 3 advantages of a spring cantilever bridge?
* Replace space between upper incisors * where adjacent teeth not restored * where a posterior would be a suitable abutement (have a crown or a large direct restoration)
69
What are 4 disadvantages of a conventional spring cantilever bridge?
* Can only be used to replace upper incisor teeth * Difficult to clean beneath palatal connector * May irritate the palatal mucosa * Difficulty to control movement of pontic (due to springiness of metal arm and displacement of palatal mucosa)
70
What are 3 ideal properties of an abutement tooth in conventional bridgework?
* Must withstand forces previously directed to the missing teeth * Healthy supporting tissue and free of inflammation * 2:3 crown to root ratio , minimum 1:1 crown to root ratio
71
What type of study casts would you take for a bridge?
Face-bow mounted study casts on a semi-adjustable articulator
72
5 things to note about the patient occlusion when designing a bridge?
* Incisal classification * Guidance (canine or group function) * Opposing tooth (if overerupted) * Occlusal interference of bridge * Signs of parafunctional habits (wear, attrition)
73
What 3 functions of the pontic in bridges?
* Restore appearance of missing tooth * Stabilise the occlusion * Improve masticatory function
74
What 3 things to consider when choosing a pontic design?
* Cleansability * Appearance * Strength
75
3 ways to achieve cleansability in the pontic design?
* Always smooth with glazed surface * Surface should not harbour join of procelain and metal at occlusal contacts * Embrasure space should be smooth and cleansable
76
What affects the decision of thickness of pontic design?
The length of the span , as the longer the thicker
77
Which surface of the pontic should be the narrowest? and why?
Occlusal surface to enable cleaning
78
What is on the approximal surface of the pontic?
* Connector - strength * Embrasure - space
79
What are 5 types of pontic designs?
* Wash-through * Dome pontic * Modified ridge lap pontic * Ridge lap pontic * Ovate pontic
80
What is wash-through pontic
* Makes no contact with soft tissue * Good function and easy to clean * Consider in lower molar area due to its poor aesthetics
81
What is Dome-shaped pontic?
* Bullet shaped * lower incisors, premolar or upper molar area * Acceptable if 2/3 of buccal surface is visible
82
What is modified ridge lap pontic?
* Buccal surface looks as much like as tooth as possible * Lingual surface is cut away * Line contact with buccal of ridge
83
What problems may be encountered with modified ridge lap ?
* food packing in lingual surface of ridge
84
What are 2 advantages of modified ridge lap design?
* Good aesthetic on buccal aspect * Good cleans-ability of the lingual side
85
What a ridge lap / saddle pontic?
* Greatest contact with soft tissue * Can be cleaned if designed carefully
86
Disadvantages of ridge lap pontic?
* Need optimum oral hygiene * May cause blanching of soft tissue
87
What are the advantages of ridge lap pontic?
* Good aesthetics * Less food packing than modified ridge lap
88
What materials are used in bridgework? (4)
* All metal - Gold, NiCr, CoCr, SS * Metal ceramic * All ceramic - zirconia , lithium disilicate * Ceromeric - porcelain + composite
89
Where to use metal and why?
Lower posterior area especially gold * Can withstand occlusal forces * No high aesthetic demand
90
What material are majority of bridges made of?
* Metal ceramic Metal for strength and ceramic for aesthetics
91
2 methods of implant retained bridges?
* Screw retained * Cement retained
92
What would you request from the lab to construct during preparation? and why?
* vacuum formed stent * allow checking reduction during preparation * allow construction of provisional bridge
93
Ways to achieve parallelism during preparation of bridgework?
* By direct vision - one eye closed ,mouth mirror, using a probe like a surveyor * By surveyed cast extra-orally
94
How to increase retention in preparing for bridgework?
* Slots * Grooves
95
What would you use to cement all metal conventional bridge?
GI or RMGI luting cement
96
What would you use for a metal ceramic bridge cementation?
GI or RMGI luting cement
97
What cement would you use to cement RRB?
Anaerobic duel cure resin cement with 10-MDP
98
What cement would you use to cement all ceramic cement?
Duel cure resin cement
99
Why should you avoid distal cantilever designs?
because occlusal forces on Pontic will produce leverage forces on abutment tooth causing it to tilt
100
When might you consider distal cantilever?
* In shortened dental arch situation * From premolar if unopposed or opposed by a denture
101

BDS4 Exam Perp (72 decks)

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