Bridgework 2 Flashcards
What are general indications for bridgework?
Function and stability of dentition
Speech
psychological reasons - rpd can be too much for pt
systemic disease - epileptic pt (seizure resulting in fracture or inhalation)
cooperative pt - good OH, wanting to maintain dental health
What are general contra-indications for bridgework?
uncooperative pt - poor oh, not willing to improve
MH contraidicnations - allergy
Poor OH
High caries + active disease
PD until adressed or improved
large pulps, young teeth - risk of pulp exposure
What are some local idincations for bridgework?
big teeth - greater retention and resistance
heavily restored adj teeth - good for conventional
favourable abutment teeth
favourable occlusion
What are some contraindications (loca) for bridgework?
High occlusal load
tilting and occlusal load
high chance of further tooth loss within arch
poor prognosis of abutment teeth
length of span too long - flex and fracture
ridge form and tissue loss (dente replaces yes soft tissue and hard tissue)
degree of restoration - if not much tooth left after prep
PA status
PD status
What are some types of conventional bridges? (4)
Conventional bridge (fixed fixed or cantliver)
Fixed moveable bridges
Hybrid bridge
Spring cantilever
What is a fixed-fixed bridge?
Retainer –> pontic –> retainer
theres a retainer at eachch end with Pontic in middle (retainer is on abutment teeth)
Where are fixed-fixed bridges most common?
Posterior teeth
When can we use a longer plan bridge?
if pt has class II incisal relationship then there is not much occlusal contact from lower teeth onto upper teeth so teeth not in occlusion so bridge wont be subject to high occlusal forces and wont flex as much
Pt with AOB - upper anterior dont occlude with lower anterior and Pontic is kept clear of occlusion
What are 5 advantages of fixed-fixed conventional bridges?
Robust
Maximise retention and strength as crown is retainer
abutment teeth can be splinted together (good in perio cases with mobile teeth - we can consider fixed-fixed design to splint teeth educing mobility)
Can be used in longer spans (can replace 6 and 5 using 4 and 7)
Lab construction is easy - impression –> lab
Why are fixed fixed conventional bridges more robust?
As we can use larger connectors between abutment and Pontic so more of a solid solution that can withstand occlusal forces
What are 4 disadvantages of fixed fixed conventional bridges?
preparation is difficult (parallel prep for common POI)
Minimally tapepered prep (5-7 degrees) to increase retention
Common POI for abutments
results in extensive tooth tissue removal (risk of pulp exposure)
What happens if abutment teeth are parallel?
if we prepare teeth and preps aren’t parallel technician will make. bridge that has POI largely based on one tooth and as a result wont seat as teeth have different paths of insertion
What is a potential solution if abutment teeth no parallel?
fixed moveable bridge
What issue can fixed moveable bridges fix?
If abutment teeth have different pathos of insertion resulting in us unable to fir bridge due to adjacent teeth interference
to get them parallel wed have to do extensive prep to aspects of teeth which is destructive
What is a fixed moveable bridge?
This is a type of conventional bridgework that consists of two components (we prep two abutment teeth and the teeth have different longitudinal axis and POIs so the bridge comes back in two parts - one initial down goes on one tooth and sits on one POI and other component that has Pontic and retainer on other tooth slides on other way and then these components slide together with male component which goes into female component like a jigsaw piece)
