Intro To Bridgework 2 Flashcards
Explain conventional bridge
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
Terminology for bridges
Connector, Pontic and retainer are joined
Pontic seats over edentulous ridge
Retainer fits over abutment preparation (on the abutment tooth)
What are the various bridge designs
Fixed-fixed
Cantilever (favoured design)
Fixed-movable
Adhesive (Resin bonded bridge)
Watch the lecture discussing each of the previous designs
What are the clinical procedures in making conventional bridges?
Abutment preparation
Impressions
Occlusal Registration
Shade Taking
Temporary Bridge Placement
Try-in of casting
Checks prior to bridge cementation
Trial cementation
Final cementation
Review
Abutment preparation
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
Impressions
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.,
Occlusal registration
In either wax or PVS
Shade taking
Individual teeth in a bridge might have different shades
Temporary bridge taking
Made chairside or laboratory (heat cured acrylic)
Try in of casting
Esp in extensive bridgework bc you might need to section or relocate
Before and during, after bridge cementation
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
Review
Review OHI, caries, debonding from retainers and periodontal support
Radiographs for future caries periodontal or endodontic issues
Impressions…
Watch the lecture
What are pontics and what is their purpose
Designed to serve the three main functions of a bridge
To improve appearance
To stabilize the occlusion
To improve masticatory function
Principles of designing a Pontic
- Cleansability
- Appearance
- Strength
Cleansibility
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
Appearance
Aesthetic
Tooth-like
Where conflict exists between cleansability and appearance, priority should be given to cleansability
Strength
The pontic must be able:
To withstand occlusal force
The longer the span the greater the occlusal-gingival thickness of the pontic
Pontic designs
Ridge Lap
Modified Ridge Lap
Hygienic / Sanitary
Ovate
Bullet
Advantages of a ridge lap Pontic
Maximum aesthetics
Fully contoured pontic on the buccal and lingual surfaces to fully fill the available space.
Full contour gives ideal aesthetics
Disadvantage of a ridge Lap Pontic
Very difficult to clean and maintain
What is a modified ridge lap Pontic
Full contour on the buccal side only, material is cut away on lingual side to provide cleansibility.
What are the advantages of a ridge lap Pontic
Provides adequate facial aesthetics and increases hygienic access to gingival of pontic.
