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Fixed Pros II > Treatment Planning and Biomechanics > Flashcards

Treatment Planning and Biomechanics Flashcards

1
Q

what is a fixed partial denture/ bridge

A

a dental prosthesis definitively attached to remaining teeth or to dental implants which replaces one or more missing teeth

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2
Q

what is the abutment

A

natural tooth or implant serving as attachment for FPD

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3
Q

what is the retainer

A

extra coronal restoration cemented to abutment

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4
Q

what is the pontic

A

artificial tooth suspended from abutments

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5
Q

what is the connector

A

rigid or non rigid connecting pontic and retainers

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6
Q

what is the edentulous ridge

A

the site of the alveolar bone and its covering soft tissues that remains after tooth loss

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7
Q

what is the state of dynamic equilibrium

A

equal pressures keeping teeth in their locations

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8
Q

what are the possible consequences of unrestored tooth loss

A
  • tooth movement
  • no tooth movement
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9
Q

what are the types of tooth movement seen in unrestored tooth loss

A
  • over eruption
  • tilting and drifting
  • disruption of occlusion: pain and TMJ dysfunction
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10
Q

what are the options for a partially edentulous patinet

A
  • RPD
  • tooth supported FPD- conventional, resin-bonded, or cantilever
  • implant supported FPD
  • do nothing
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11
Q

what are the indications for RPD

A
  • long edentulous spans
  • no distal abutment
  • multiple edentulous spaces
  • abnormal abutments- tipped, divergent or few abutments
  • periodontally weakened primary abutments
  • severe loss of tissue/bone in residual ridge
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12
Q

what is key for the success of a bridge

A

occlusion

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13
Q

what are the indications for a FPD

A
  • to replace function of missing teeth
  • to stabilize occlusion and keep teeth from drifting and extruding
  • to create esthetics and phonetics
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14
Q

where should the abutments be placed so they are properly distributed

A
  • abutment on both ends of edentulous spaces
  • span length falls within structural limits
  • straight alignment of restoration
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15
Q

what are the requirements for abutment strength

A
  • abutments need to be restorable
  • periodontally sound and stable
  • no questionable pathology
  • occlusal harmony
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16
Q

what are the contraindications for FPD

A
  • excessive loss of alveolar bone
  • abutments not restorable
  • abutments are periodontally compromised
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17
Q

why is FPD contraindicated with excessive loss of alveolar ridge

A
  • difficulty cleaning
  • difficulty making esthetic
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18
Q

how can you correct excessive loss of alveolar ridge

A

bone graft or augmentation with perio surgery

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19
Q

what would make abutments not restorable for a FPD

A
  • short clinical crown
  • heavily restored already
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20
Q

what would qualify abutments as periodontically compromised

A
  • loss of bone
  • crown to root ratio
  • span between abutments are too long
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21
Q

what do you do with virgin or minimally restored abutments

A

purse implant options for the missing tooth

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22
Q

what does the ideal FPD look like

A
  • periodontally sound abutments
  • tissue follows contour of pontic and connector
  • span is within structural parameters
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23
Q

what are the criteria we use for abutment evaluation

A
  • restorative assessment
  • endodontic assessment
  • periodontal assessment
  • abutment positional assessment
  • radiographic assessment
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24
Q

what is included in the restorative assessment

A
  • coronal tooth structure
  • previous restorative treatment
25
Q

what is included in the endo assessment

A
  • pulp staus- vital or non vital
  • PARL
  • previous endo in -tact?
26
Q

what is included in the periodontal assessment

A

crown to root ratio, root configuration, periodontal surface area

27
Q

what is included in the abutment positional assessment

A

is the tooth tilted? inclined?
- what is the tooth orthodontic position?
- is the path of insertion achievable?

28
Q

how recent should PA radiographs be to be considered current enough to confirm the health of abutments

A

less than 6 months old

29
Q

what are the periodontal health qualifications for FPD

A
  • need a zone of attached tissue
  • no mobility
  • patient home care adequate
30
Q

what is the optimum crown to root ratio

A

2:3

31
Q

what is the minimum crown to root ratio for fixed restoration

A

1:1

32
Q

the conical root shape _____ the area of support more than expected from the height of bone

A

decreases

33
Q

the center of rotation moves ____ and the lever arm ____, greatly magnifying the forces on supporting structures

A

apically; increases

34
Q

what can a bad crown to root ratio lead to

A

increased tooth mobility
- further bone loss
- failure of FPD

35
Q

what are the exceptions to crown to root ratio guidelines

A

-if opposing occlusal forces are diminished such as
- artificial teeth - full denture or RPD
- periodontally compromised opposing teeth

36
Q

muti rooted teeth are _____ than single rooted conical teeth

A

better

37
Q

widely separated roots are _____ abutments than fused roots

A

betterl

38
Q

long roots are ____ abutments than short roots

A

better

39
Q

what is ante’s law

A

the root surface area embedded in bone of the abutment teeth should be equal or surpass that of the teeth being replaced with pontics

40
Q

how do you calculate ante’s law

A

add the abutment numbers and subtract the pontic numbers

41
Q

any FPD replacing more than 2 posterior teeth has a ______ prognosis

A

guarded

42
Q

why can maxillary FPDs replacing more than 2 posterior teeth be acceptable

A

the maxillary arch has longer crowns and less tooth inclinations

43
Q

describe the path of insertion

A

axial walls of abutment teeth must be aligned without undercuts or interferences with path of insertion of the bridge

44
Q

why can tipped teeth be difficult to prepare effectively

A
  • can expose mesial pulp horn
  • unfavorable occlusal forces if tilt is too significant
  • possible orthodontic uprighting prior to preparation
45
Q

what happens with alginate too dry or absorbed too much water

A

creates defects

46
Q

using casts you can evaluate:

A
  • edentulous spaces and span length
  • curvature of the arch
  • M-D drifting, rotations, F-L displacement of the abutments
  • inclination
  • occlusion and inter occlusal space
  • path of insertion
47
Q

what needs to be evaluated on radiographs for abutment teeth

A
  • caries
  • RCT present
  • bone levels
  • maxillary sinus
48
Q

what types of radiographs are mandatory for bridge work

A

full mouth series

49
Q

when is a marilyn bridge used

A
  • conservative enamel prep only
  • replaces missing maxillary lateral incisors with slight to moderate tissue resorption in missing tooth area
  • used in younger patients
  • in areas of light occlusal stresses and good alignment of neighboring teeth
50
Q

when is a marilyn bridge not used

A

in deep vertical overlaps AKA deep bites

51
Q

how is the marilyn bridge bonded

A

resin bonded

52
Q

what is the characteristic appearance of the marilyn bridge

A

wings from canine to canine lingual surface

53
Q

what is a cantilever

A

a FPD that has abutments at one end with the pontic remaining unconnected on the other end

54
Q

what are the indications for an implant supported FPD

A
  • implant abutments are soundly integrated
  • implant parallelism
  • availability of bone to support implant
  • patient demonstrates adequate home care
55
Q

what are full arch implant supported FPD’s down sides

A
  • $25,000 per arch
  • patient cant remove
  • hygiene is a huge challenge
  • need to be replaced every 10 years
56
Q

what are the limitations of implant placement

A
  • amount of bone
  • location of bone
  • anatomy
57
Q

what is needed for the best prognosis of bone for implants

A

vertical loading of implants

58
Q

what anatomy needs to be evaluated for implants

A
  • maxillary sinus
  • inferior alveolar nerve
  • anterior angulation of bone
59
Q
A

Fixed Pros II (13 decks)

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