Bridgework - Operative Techniques Flashcards
What is a bridge prosthesis?
Dental prosthesis used to replacing missing tooth/teeth - it is a fixed prosthesis
tx option for missing/unrestorable teeth
What are adhesive bridges?
Bridges that bone to tooth by metal wing/wings and require minimal/no prep of tooth enamel
When are adhesive bridges good for use?
Young pts - minimal prep
conservative approach - prevents descturciton of healthy tooth tissue
cantilever better (as one side only)
How do we increase retention of bridges?
Maximime avaiblae bonding surface area
sandblast fitting suface - creats pitting in surface which allows interlocking when bonding with composite cement
cutting grooves and rests in prep
use of rests seats to maximise bonding and direct axial forces down long surface of teeth
What are clinical indications for adhesive bridgework? (12)
Young ps (hypodontia and filling space until impkants)
missing teeth
SDA and we want distal extension
Unrestored abutment teeth
Sound abutment teeth
Medically compromised pts (epilepsy etc)
Space maintainers
What are clinical contra-indications of adhesive bridges?
Not enough SA for bonding
poor quality enamel for bodning
high caries
Active PD
Long span of edentulous area
Poor pt motivation
diastemas
sports - rugby or high contact sports increasing risk of bridge debunking
translucent incisal edges - poor aesthetics
tipped or misaligned teeth
What are advantages of minimal tooth prep?
No loss of healthy tooth tissue
can use unrestored teeth as abutments
good in immature teeth (large pulps)
Small teeth
conservative approach
cost effective
What are disadvantages of minimal tooth prep?
Increased failure rate
Debonding risk (partially) –> caries
Aesthetics (in incisors edge translucent then metal shine through)
can only be used for short spans (often single teeth)
no trial period
Why do we prefer one abutment tooth with adhesive cantilever bridges? 2
OH
different divergent guidance paths - all anterior teeth have different divergent guidance paths which is where the long axis of tooth is different meaning forces are directed differently down all teeth
What type of fixed fixed adhesive bridge do we avoid?
Anterior
How do we design retainer abutment tooth for metal framework?
0.5mm lingual reduction
0.1mm occlusal
180 degree wrap around
grooves
rests
for minimal prep can remove cingulum undercut
HWhat Pontic do we use for anterior and posterior?
Modified ridge lap
domed for posterior
HWhat Pontic do we use for anterior and posterior?
Modified ridge lap
domed for posteriorH
How do we do hevavy prep of anterior teeth?
Cingulum rest
incisal guide finish line
How do we do hevavy prep of anterior teeth?
Cingulum rest
incisal guide finish line
