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CONS > Intro To Bridgework 2 > Flashcards

Intro To Bridgework 2 Flashcards

1
Q

Explain conventional bridge

A

Fixed prosthodontic solution for missing teeth
Crowns are placed on abutment tooth / teeth to retain the bridge
As with provision of crowns: natural tooth tissue is sacrificed so technique is mostly used for heavily restored abtments

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2
Q

Terminology for bridges

A

Connector, Pontic and retainer are joined
Pontic seats over edentulous ridge
Retainer fits over abutment preparation (on the abutment tooth)

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3
Q

What are the various bridge designs

A

Fixed-fixed
Cantilever (favoured design)
Fixed-movable

Adhesive (Resin bonded bridge)

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4
Q

Watch the lecture discussing each of the previous designs

A
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5
Q

What are the clinical procedures in making conventional bridges?

A

Abutment preparation
Impressions
Occlusal Registration
Shade Taking
Temporary Bridge Placement

Try-in of casting
Checks prior to bridge cementation
Trial cementation
Final cementation
Review

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6
Q

Abutment preparation

A

Should be done after planning the prosthesis as the amount of prep will vary according to the design- metal more and porcelain less tooth reduction.
Metal collar (chamfer margin bucally) and porcelain wider shoulder bucally

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7
Q

Impressions

A

Elastomeric impression of abutments often with the use of a gingival retraction cord
Electrosurgery may be needed for subgingival preparations
Irreversible hydrocolloid impression of the opposing arch is necessary.,

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8
Q

Occlusal registration

A

In either wax or PVS

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9
Q

Shade taking

A

Individual teeth in a bridge might have different shades

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10
Q

Temporary bridge taking

A

Made chairside or laboratory (heat cured acrylic)

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11
Q

Try in of casting

A

Esp in extensive bridgework bc you might need to section or relocate

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12
Q

Before and during, after bridge cementation

A

Check marginal fit, occlusion, aesthetics, contact points, access for cleaning, speech
Temporary for 1-2 weeks to allow for removal and modification
Final cementation with luting cement such as glass ionomer, sandblast and do a post cementation radiograph

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13
Q

Review

A

Review OHI, caries, debonding from retainers and periodontal support
Radiographs for future caries periodontal or endodontic issues

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14
Q

Impressions…

A

Watch the lecture

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15
Q

What are pontics and what is their purpose

A

Designed to serve the three main functions of a bridge

To improve appearance
To stabilize the occlusion
To improve masticatory function

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16
Q

Principles of designing a Pontic

A
  1. Cleansability
  2. Appearance
  3. Strength
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17
Q

Cleansibility

A

All surfaces of the pontic, especially the surface adjacent to the saddle, should be made as cleansable as possible.
Therefore the surfaces of the pontic should be:
Smooth
Highly polished
Should contain no clear junctions between materials

18
Q

Appearance

A

Aesthetic
Tooth-like

Where conflict exists between cleansability and appearance, priority should be given to cleansability

19
Q

Strength

A

The pontic must be able:
To withstand occlusal force
The longer the span the greater the occlusal-gingival thickness of the pontic

20
Q

Pontic designs

A

Ridge Lap
Modified Ridge Lap
Hygienic / Sanitary
Ovate
Bullet

21
Q

Advantages of a ridge lap Pontic

A

Maximum aesthetics
Fully contoured pontic on the buccal and lingual surfaces to fully fill the available space.
Full contour gives ideal aesthetics

22
Q

Disadvantage of a ridge Lap Pontic

A

Very difficult to clean and maintain

23
Q

What is a modified ridge lap Pontic

A

Full contour on the buccal side only, material is cut away on lingual side to provide cleansibility.

24
Q

What are the advantages of a ridge lap Pontic

A

Provides adequate facial aesthetics and increases hygienic access to gingival of pontic.

25
Q

Disadvantages of a ridge lap Pontic

A

Decreased lingual contour & increased possibility of food entrapment.

26
Q

What is a hygiene/sanitary Pontic

A

Totally open access under the pontic for hygiene.

27
Q

Advantages of a hygiene/sanitary Pontic

A

3 mm space gives simple
access for hygiene &
decreases the possibility of
food entrapment.

28
Q

What are the disadvantages of a hygiene/ sanitary Pontic

A

Aesthetics due to lack
facial & lingual contour.

29
Q

What is an ovate Pontic

A

Egg-shaped end that protrudes into a concavity in the edentulous tissue. Appears that the pontic is emerging from the tissue.

30
Q

Advantages of an ovate Pontic

A

Superior aesthetics

31
Q

Disadvantages of an ovate Pontic

A

Disadvantages
Requires a wide ridge

32
Q

What is a bullet Pontic

A

Comes to a pointy area which challenges the tissue.

33
Q

Advantages of a bullet Pontic

A

Increased hygienic access
to buccal & lingual
surfaces. Can be used
against a variety of
ridges.

34
Q

Disadvantages of a bullet Pontic

A

Disadvantages
Decreased aesthetics due
to lack of full contour on
the facial & lingua

35
Q

Choice of Pontics?

A

Anterior and posterior

36
Q

Anterior pontics?

A

Modified Ridge Lap pontic is suggested due to aesthetics. Ovate can be used where the soft tissue is favourable.

37
Q

Posterior pontics

A

Modified Ridge Lap pontics are the most widely used pontics in the posterior region due to combination of aesthetics and hygiene.

38
Q

Anterior pontics

A

Modified Ridge Lap pontic is suggested due to aesthetics. Ovate can be used where the soft tissue is favourable.

39
Q

Complications with conventional bridgework

A

Caries
Loss of vitality of abutment teeth
Loss of retention
Periodontal disease / mobility of abutment teeth
Tooth fracture
Prosthesis fracture

40
Q

Bridge repair considerations?

A

Aesthetics
Function
Cost
Clinical Implications
Patient wishes

41
Q

Bridge repair options

A

Leave
Repair
Replace

42
Q

Conclusion with bridgework

A

Clinical stages of bridge construction
Variety of pontic designs available
Pontic design should be stated by the clinician
Complications with conventional bridges
Always consider why a fixed prosthesis has failed or fractured before replacing it.

CONS (10 decks)

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