Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 CDS Operative / Restorative > Bridgework 3 > Flashcards

Bridgework 3 Flashcards

1
Q

alternatives to bridgework

A

no restoration

denture(s)

implant(s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

holistic tx planning

A
  • Look at the whole mouth
  • Not only at a specific tooth
  • Plan for retrievability (always have a back-up plan)
    • All restorations will eventually fail
    • What will be options? Replace like for like? More destructive resort?
  • What will the dentition be like in 10-years?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

longevity of RBB

A

80% over 5-10years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

longevity of cantilever bridge

A

80% over 5-10years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

longevity of fixed-fixed over 5-10years

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

collect information when gathering pt history in regards to bridge planning

A
  • History
    • Presenting complaint
    • Medical and social history
    • Past dental history
      • attendance, OH
  • Clinical examination (Extra- and intra-oral)
    • Soft tissues
    • Periodontal
    • Caries risk assessment
    • Occlusion
    • Parafunction
  • Abutment evaluation
    • Remaining tooth structure
    • Special tests
      • Radiographs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

occlusal information for bridgework planning

A
  • Examine:
    • Intra-orally
    • Study casts
      • Facebow-mounted on semi-adjustable articulator
  • Incisal classification (ortho lectures)
  • Canine-guided or group function?
  • Opposing tooth over-erupted?
    • Reducing interocclusal space
  • Will bridge interfere with current occlusion?
    • Will it be changed when bridge placed?
  • Signs of parafunction present?
    • Wear facets, attrition etc.
      • Bruxism – risk of destroying bridge when placed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

evaluation of potential abutments when designing and planning bridges (8)

A
  • Root configuration
    • Big or multi rooted best
  • Angulation/rotation of abutment
  • Periodontal health
  • Surface area for bonding & quality of enamel
  • Risk of pulpal damage
  • Quality of endodontics:
  • Remaining tooth structure present?
  • Core
    • Remove and rebuild?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

options for bridge design (3 main groups with subgroups)

A
  • Resin-bonded/Resin-retained/Adhesive
    • Cantilever
    • Fixed-fixed
  • “Conventional”
    • Cantilever
    • Fixed-fixed
    • Fixed-moveable
  • Hybrid
  • Spring Cantilever Bridge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pontic design

5

A
  • Wash-through pontic
  • Dome/Bullet/Torpedo
  • Modified ridge lap
  • Total ridge lap
  • Ovate pontic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 functions of pontic

A
  • restore appearance of missing tooth
  • stabilise occlusion
  • improve masticatory function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 considerations for pontic design

A

cleansability

appearance

strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cleansability in pontic design

A
  • Should always be smooth, with highly polished or glazed surface
  • Surface should not harbour join of metal and porcelain (if metal-ceramic design used)
    • Shearing off due to occlusal force
  • Embrasure space smooth and cleansable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

appaerance for pontic design

A

anteriorly - as ‘tooth like’ as possible

posteriorly - may compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

strength for pontic design

A

longer the span - greater the thickness required to withstand occlusal forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

4 surfaces of pontic

A
  • Occlusal surface
    • Resemble surface of tooth it replaces
    • Narrower if possible to enable cleaning
    • Should have sufficient occlusal contact so can function
      • Need driven down long axis of tooth
  • Approximal surface
    • Connector: strength (roughly 2 by 2 mm for strength)
    • Embrasure: space – floss/interdental, but want to try and reduce for aesthetic
  • Buccal & lingual surface
  • Ridge surface
17
Q

wash through pontic design

A

no contact with soft tissue

fucntional rather than for appearance

consider in lower molar area

easy to clean

a.k. hygienic or sanitary

18
Q

dome shaped pontic design

A

useful in lower incisor, premolar or upper molar areas

acceptable if occlusal 2/3 of buccal surface visible - poor aesthetics if gingival 1/3 of tooth visible

good for cleaning

a.k.a torpedo or bullet shaped

19
Q

modified ridge lap pontic design

A

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

20
Q

ridge lap/saddle pontic design

A

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

21
Q

ovate pontic design

A

good for OH good pt

and want optimal aesthetics

presses on gingivae, looks like natural tooth piercing out of ginivae

22
Q

materials for conventional bridges

A
  • All metal
    • Gold
    • Nickel/Cobalt chromium?
    • Stainless steal
  • Metal ceramic
  • All ceramic – more likely to #, but starting to rival MC
    • Zirconia – very strong, but less aesthetic than lithium disilicate
      • E.g. LAVATM and Procera®
    • Lithium disilicate
      • e.g. - E.max
  • Ceromeric (porcelain with composite), less used
    • BelleGlass™
    • Vectris®
    • Targis® Vectris®
23
Q

common place for all metal bridges

A

lower posterior area (gold)

24
Q

metal ceramic bridges usually

A

make up the majority of bridges made in UK currently

25
Q

LavaTM 3M ESPE bridges

Zirconia

A
  • 3 – 4 unit fixed bridge (Maximum span) milled zirconium oxide frame with feldspathic porcelain overlying
  • Withstand occlusal forces
  • Good aesthetics
  • Similar reduction to MCC
26
Q

zirconia bridge

A
  • GDH&S Fixed Pros lab now producing more all ceramic restorations
  • Preparations on casts scanned
    • Straűmann© – 7 Series by Dental Wings
    • Nobel BioCare © – Series 5
  • KATANA© zirconia
    • Multi-layered (ML) zirconia
    • Ultra translucent multilayer (UTML) zirconia
  • Milled
  • +/- feldspathic (layer) porcelain on top
27
Q

implant retained bridges

for

types

A

large span bridges

screw-retained or cement retained

28
Q

technique for conventional bridgework

A
  • Mounted study models
  • Consider diagnostic wax-up and custom impression tray
  • Request laboratory to construct vacuum-formed stent
    • Allows checking of reduction during tooth preparation
    • Allows construction of provisional bridge
  • Select shade
  • Laboratory made stent or make pre-operative putty impression for provisional bridge
  • Occlusal or incisal reduction
  • Separation of teeth
  • Aim for parallelism of tapered surface of each preparation
    • Example: Preparation of fixed-fixed bridge for 13 12 11
      • Prep mesial of 11, then mesial of 13
      • Prep distal of 11, then distal of 13
      • Prep labial (2-planes) of 11, then labial 13 …..etc
  • Confirm parallelism
  • Consider retentive features if short clinical crown height or overtapered
    • Slots
    • Grooves
  • Construct provisional bridge (do first before definitive imp)
  • Make impression and occlusal registration
  • Temporarily cement provisional bridge
  • Demonstrate cleaning with Superfloss™
  • Write/draw prescription for technician – be specific
    • Type of bridge
    • Abutment teeth
    • Pontic teeth
    • Shape of pontic
    • Material to be used
29
Q

parallelism

A

Consider for fixed-fixed conventional bridge

  • Common POI – increased retention
  • No undercuts

Paralleling by eye

  • Direct vision, one-eye closed
  • Large mouth mirror (posteriorly)
  • Use of a straight probe like a laboratory surveyor, but in the mouth

Extra-oral survey

  • Quick impression
  • Pour a model
  • Use a laboratory surveyor; useful in long span multiple unit bridges
30
Q

definitive cementation for all metal conventional bridgework (2 options)

A
  • Aquacem (GI luting cement)
  • RelyX™Luting (RMGI luting cement)
31
Q

defintive cementation for metal ceramic bridgework (2 options)

A
  • Aquacem (GI luting cement)
  • RelyX™Luting (RMGI luting cement)
32
Q

defintive cementation for adhesive/resin-bonded/resin-retained bridgework

A

Panavia 21 (anaerobic dual cure resin cement with 10-MDP)

10-MDP helps tooth stick to metal work

33
Q

definitive cementation for all ceramic bridgework

A

NEXUS®/ NX3 kit (dual cure resin cement)

34
Q

distal cantilevers

A

Avoid if possible

  • Occlusal forces on pontic –> leverage forces on abutment tooth causing it to tilt

May consider in shortened dental arch, pontic 5, abutment 4
(unopposed/ opposed by denture)

35
Q

longevity

A

BDS4 CDS Operative / Restorative (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions