Bridgework 1 Flashcards
(31 cards)
tx options for missing tooth / teeth
- no tx i.e. leave space
- replace tooth / teeth
- close space i.e. ortho
4 reasons for tx of tooth loss
- aesthetics
- function
- speech
- maintenance of oral health
3 options for tooth replacement
- denture
- bridgework
- implants
what is a bridge
a prothesis which replaces a missing tooth or teeth and is attached to 1 or more natural teeth (or implants)
basically a fixed partial denture
2 main types of bridgework
- adhesive - held on with ‘wings’ that go on palatal surfaces of abutment teeth
- conventional - held on with crowns on abutment teeth
general indications for bridgework
- function & stability
- appearance
- speech
- psychological reasons
- systemic disease e.g. epileptics
- cooperative pt
local indications for bridgework
- big teeth
- heavily restored teeth
- favourable abutment angulations
- favourable occlusion
general contraindications for bridgework
- uncooperative pt
- medical hx
- poor OH
- high caries rate
- periodontal disease
- large pulps (more in conventional bridge)
local contraindications for bridgework
- high possibility of further tooth loss within arch
- prognosis of abutments poor
- length of span too great
- ridge form & tissue loss
- tilting & rotation of teeth
- degree of restoration i.e. how much tooth left after prep
- periapical status
- periodontal status
pontic
artificial tooth which is suspended from the abutment teeth / tooth
retainers
extra / intracoronal restorations that are connected to the pontic & cemented to the prepared abutment teeth
connectors
component which connects the pontic to the retainers / retainer
pier
an abutment tooth which stands between and is supporting 2 pontics, each pontic being attached to a further abutment tooth
conventional bridge
retainer = crown
can have fixed fixed, fixed cantilever, fixed moveable
adhesive bridge
retainer = metal (NiCr or CoCr)
minimal or no prep
wing of metal comes off the side of the pontic and is attached to palatal surface of abutment tooth
cantilever
bridge has a retainer on only 1 side of the pontic
retainer can be a conventional crown retainer or an adhesive / resin retained metal wing
fixed fixed
retainers on both sides of pontic that are joined by rigid connectors
retainers tend to be crowns which are all ceramic or MCC
mostly posterior teeth
+ of conventional fixed fixed bridge
- robust design
- maximum retention & strength
- abutment teeth splinted together
- can be used in longer spans
- lab construction straightforwards
- of conventional fixed fixed bridge
- prep difficult (parallel tooth prep needed)
- prep must be minimally tapered (5-7 degrees)
- common path of insertion for both abutments
- removal of tooth tissue (danger to pulp)
+ of conventional cantilever bridge
- conservative design compared to fixed fixed conventional design
- lab construction straightforward
- no need to ensure multiple tooth preps are parallel
- of conventional cantilever bridge
- short span only
- rigid to avoid distortion
- mesial cantilever preferred
why is a mesial cantilever preferred
in this case the retainer is the more posterior tooth and the pontic is further anterior
this is because when the pt occludes they are more likely to make contact with their posterior teeth first
fixed moveable bridge
has a rigid connector usually at the distal end of the pontic & a moveable connector mesially
allows some vertical movement at the mesial abutment tooth
+ of conventional fixed moveable bridge
- prep doesn’t require a common path of insertion
- each prep designed to be retentive independent of others
- more conservative of tooth tissue
- allows minor tooth movement
- may be cemented in 2 parts
