Simple bridgework Flashcards
bridgework = basic principles
caries removal
keep as much sound tooth tissue
maintain pulp and periodontal health
longevity
occlusal stability
aesthetics
must be cleanable
thorough case assessment
bridgework - planning and consent considerations
study casts/digital planning
diagnostic wax ups
reasonable alternatives
costs and timescale
aesthetic expectations
longevity/cycles of replacement
effects on tooth health
materials
consider the daughter test
types of bridges
adhesive
- resin bonded
conventional fixed bridge
conventional cantilever bridge
others
- spring cantilever
- natural tooth
- bridge on telescopic crowns
adhesive bridge work - advantages
minimal or no preparation required
often no anaesthetic needed
less expensive
less surgery time
can be used as a provisional restoration
usually less destructive than alternatives if it fails
adhesive bridge work - disadvantages
rigorous clinical technique
metal shine through
can debond - repetitively
chipping porcelain
occlusal interferences
no trial period possible
conventional bridgework - advantages
useful for heavily restored teeth
good aesthetics
can temporise and cement provisionally
strong so useful in high loads
debonds less often than adhesive bridges
transfers occlusal load to roots
conventional bridgework - disadvantages
expensive
destruction of tooth tissue
long appointment times
requires very high standard of oral health
failure may result in tooth loss
risk of pulpal damage
why do adhesive bridges generally have one wing?
2 abutments increases torque on least mobile abutment and risks “sprung” bridge
Adhesive bridges - ideal cases
low occlusal forces
missing lateral incisors
splinting role
large occluso-gingival height
adhesive bridges - cases where you should approach with caution
bruxists
canines as poetics
lack of posterior support
deep overbite
small occluso-gingival height
lack of enamel
