Fixed Immediate Replacements

Question 1

Name the 3 advantages of fixed options?

Answer 1

Psychological
Biological
Functional

Question 2

What are the the psychological advantages of fixed options?

Answer 2

If own tooth used, reduces the impact of “loss”
Looks and feels the same as before- no adaptation to new “body image”
No need to remove – is part of the patient, no embarrassment

Question 3

What are the the biological advantages of fixed options?

Answer 3

No additional soft tissue coverage
No increase in plaque retention
Maintains interdental space effectively - worn constantly unable to remove

Question 4

What are the the functional advantages of fixed options?

Answer 4

Speech is unaffected
Cannot be easily lost
Less susceptible to breakage
Minimal need for patient adaptation

Question 5

Explain the process to prepare a recently extracted tooth for fixed immediate replacement?

Answer 5

Extraction + cleaning
Tooth decoronated
RC sealed with GIC
Ortho wires attached
Tooth carefully positioned and attached to adj teeth using composite resin
Occlusion was carefully checked and adjusted

Question 6

Explain the process to prepare an acrylic tooth for fixed immediate replacement?

Answer 6

Model made prior to extraction
Lab cuts tooth from model
Trims acrylic denture tooth to fit space and occlusal scheme
Adds orthodontic wire for bonding to adjacent teeth
Acrylic denture tooth to fit space and occlusal scheme
Orthodontic wire for bonding to adjacent teeth

Question 7

Explain the process to prepare asemi-permanent solution for fixed immediate replacement?

Answer 7

Prepare palatal surfaces of both the pontic and abutment teeth
Make working casts of upper and lower arches
Cut tooth to be replaced from the model
Reposition the “extracted” tooth
Construct metal framework for retentive elements
Extraction of the affected tooth
Partially decoronate tooth
Widen canal access and irrigate with sodium hypochlorite solution
Complete trimming of the tooth to the correct gingival length and contour.
Seal the opening to the pulp chamber with glass ionomer cement.
Position tooth on metal retainer and bond with bonding agent.
Position the bridge retainer accurately against the abutment tooth and check fit and asestetics.
Carefully isolate the abutment tooth. Wash and dry the retainer.
Bond the bridge into position using appropriate bonding agent.