FDP splinted provisional and pontic design

Question 1

splinted provisional vs single unit provisions

Answer 1

1) protect teeth and abutments
2) restore function and balance occlusion
3) hold the tooth in position
4) pulp protection
5) maintain periodontium
6) prevent fracture
7) provide aesthetics

but… more time and more challenging

Question 2

components of splinted provisional

Answer 2

1) retainer
2) connector
3) pontic

Question 3

pontic

Answer 3

1) needs to be hygienic and cleansable
2) protect periodontium
3) prevent irritation of residual ridge
4) resist occlusal forces

Question 4

optimal pontic design

Answer 4

1) rigid and cleansible
2) provide access to abutment
3) no pressure on the ridge
4) proper contours
5) esthetic

Question 5

mucosal contact

Answer 5

1) ridge lap
2) modified ridge lap
3) ovate
4) conical

Question 6

no mucosal contact

Answer 6

1) sanitary
2) modified sanitary

Question 7

sanitary//hygienic

Answer 7

1) easy cleaning
2) entrapment of food
3) floss pass under pontic
4) least tooth like design
5) mandibular molars
—
1) when perio health is an issue
2) does not contact with ridge
3) proximal areas of the adjacent abutments are free of obstructers
4) requires adequate vertical dimension of occlusion

Question 8

conical

Answer 8

1) egg shape
2) easy to clean
3) one point of tissue contact
4) posterior teeth
5) poor esthetic
6) suitable for broad residual ridge

Question 9

ovate

Answer 9

1) most esthetic
2) anterior region, maxillary incisors
3) socket preservations technique at time of extraction
4) require prep for pre existing residual space
- surgical augmentation

Question 10

saddle/ridge lap

Answer 10

1) DO NOT
2) concave fitting surface overlapping the ridge buccolingually

Question 11

modified ridge lap

Answer 11

1) most common pontic design used in areas that are visible
2) overlaps ridge on the facial for esthetics but clear of the ridge on the lingual for cleansibility
3) ridge contact only extends to the crest of the ridge
- ideally a “T” shape

Question 12

other considerations for pontics

Answer 12

1) ridge contact
- no pressure on ridge
- no blanching of tissue
2) good oral hygiene instructions to prevent plaque from causing ridge irritation
3) material
- glazed porcelain
- highly polished metal

Question 13

putty for provisionsal

Answer 13

1) make sure it extends to anterior teeth
- to prevent fish tailing
2) place die lube
3) fill the putty and place it on
4) shape the embrasures and pontic design
- try to get the T shape
5) make buccal side look as natural as possible
- make lingual more strong

Question 14

connectors

Answer 14

1) connectors cross section should be large as possible without compromising the periodontium
2) increasing the height is strongest
- trim the occlusal lingual embrasures on provisional putty
- on lingual, so not as visible

Question 15

mesial contact on #29

Answer 15

1) less than ideal
- too small, too lingual, too gingival
2) trim the putty mesial of #29 or add flowable to prevent breakage

Question 16

occlusion

Answer 16

1) make sure you have occlusal stops on the contralateral side
2) proper occlusion
- functional cusps
- marginal ridges
- fossa
3) improper occlusion on provision
- inclines
- premature occlusion (anywhere)