Fixed bridges Flashcards
What is a fixed dental prosthesis?
A fixed dental prosthesis is any dental prosthesis that is 🦷 luted, screwed, or mechanically attached to natural teeth, tooth roots, or implants. It provides primary support to replace missing teeth.
What are the key components of a fixed dental prosthesis?
🔐 Retainer: Crown, ¾ crown, or metal wing that attaches to the abutment
🧱 Pontic: Artificial tooth that fills the space
🧩 Abutment: The tooth/implant that supports the structure
What is an abutment in fixed prosthodontics?
It’s the part of the structure that receives occlusal forces and supports the prosthesis — either a natural tooth or an implant 🦷🔩
usually the lateral tooth
Difference between single vs. double abutment bridges?
Single abutment: Supports a cantilever bridge (pontic on one side) ➡️
Double abutment: For fixed-fixed bridges, support on both sides ⬅️🦷➡️
What are ideal abutments?
Teeth like 1s, 3s, and 6s
Good crown height, root length, and bone support
What are poor abutment choices?
🚫
Heavily restored teeth
Teeth with post-crowns/RCT
Structurally weak or mobile teeth
What is a pontic?
A false tooth that replaces a missing one, restoring function & aesthetics 🦷✨
What are the types of pontic designs and uses?
🛋 Modified Ridge Lap: Common and hygienic
💧 Ovate Pontic: Most aesthetic, needs surgical prep
🚫 Sanitary (Hygienic): Best for cleaning, least aesthetic
What is a retainer in bridgework?
The part that attaches to abutment teeth — like a full crown, ¾ crown, inlay/onlay, or metal wing 🛠
What is a conventional fixed-fixed bridge?
A bridge supported by two abutments, one on each side of the pontic 🦷🔗🦷
What is a conventional cantilever bridge?
A bridge supported by one abutment only → commonly for lateral incisors 🔗🦷
indications for conventional bridges?
✅
Heavily restored abutments
🔄 Replacing existing bridges
Good OH & motivation 🪥
Stable perio 🧼
Short edentulous span
Contraindications or conventional bridges?
❌
Unrestored or poor abutments
😬 Poor OH, caries, periodontitis
Long spans
💥 Contact sports
Low motivation
What is a resin-retained cantilever bridge?
A bridge with a metal wing bonded to enamel with minimal or no prep, usually for single tooth replacement ➡️🦷
Design features of RRBs?
🎨
Bond to enamel
0.7–0.8 mm non-precious metal wing
Use cantilever design
Avoid excursive contact ❌👅
Max contact with abutment for retention
Indications for RRBs?
Unrestored, sound abutments
🧽 Good OH
🧑⚕️ Motivated patients
Small spaces (e.g., lateral incisors)
Contraindications for RRBs?
❌
Short crowns
🦷 Heavily restored abutments
Caries or poor OH
Large gaps
😬 Bruxism, trauma, sports
What occlusal features are important in bridge design?
☁️ Light ICP contact
❌ No lateral or protrusive contact
Share guidance with other teeth
Pontic = no excursive stress
Aesthetic considerations to inform the patient?
🪞
Grey metal wing may show through
Shade match critical 🎨
Use blue wax shy of incisal edge to mask wing
What’s the step-by-step for making a conventional bridge?
🦷 Primary impression
🪄 Diagnostic wax-up
🧑🔬 Abutment prep + silicone master impression
🛡 Temporisation
🧠 Articulator work
🧪 Try-in & cementation
Common complications with bridges?
⚠️
Caries under retainer
Endodontic failure
Debonding (esp. RRBs)
Porcelain chipping
Root fracture 🦴
Aesthetic mismatch
Survival rates?
Crowns:
84% survive 10 yrs
81.2% at 15 yrs
RRBs: Debonding is biggest issue
Fixed-fixed bridges: Risk of catastrophic failure if it goes wrong 💥
What is the ‘shortened dental arch’ concept?
Replacing only anterior/mid-teeth when posterior teeth don’t critically affect function ➡️ keeps treatment conservative and cost-effective 🪙🦷
What should always be done before starting bridge treatment?
✅
Diagnostic wax-up 🔍
Check occlusal scheme 🦷↔️🦷
Pick least invasive option
Discuss risks & maintenance with patient 🗣
Anterior tooth to replace
Create gingival profile
Prepare prior to impression taking - electoral surgery
Lab will be able to create a suitable emergence profile
Why should we Avoid fixed/fixed resin retained bridges
Design used to be used 20 years ago
Replace missing teeth by using two photonics one on eahc side of saddle
In theory you bond to two teeth
HOWEVER issues,when these bridges fail, normally fail at winged tooth interface
Degradation of cement and gap and caries develop
Cantilever bridge - bridge will be loose and devon quickly
Fixed resin retained bridge
Bridge remains in situ
See failure later down the line
Caries extend significantly into tooth structure
Unable to detect debonding of the bridge
What are the key design considerations for a dental bridge? 🦷
Occlusion ⚖️:
Pontic should have light contact in ICP (centric occlusion) 🦷 and no contact in lateral/protrusive movements 🚫➡️
Occlusal Guidance 🦷:
Share the bridge’s occlusal guidance with the natural teeth 🦷👨⚕️ (where possible)
Wax Up 🕯️:
Discuss the wax up with the patient, especially in anterior bridgework 💬➡️👩⚕️
Metal Wing ⚒️:
Explain to the patient that the metal wing might show through the abutment 😬🔍
