Bridgework Flashcards by Alistair Stoddart

What is a bridge

A prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth

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What are general indications for bridgework

Function and stability
Apperance
Speech
Psychological reasons
systemic disease

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What are local indications for bridgework

Big teeth

Heavily restored teeth

Favorable abutment angulations

Favorable occlusion

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Contraindications for bridgework

Uncooperative patient

Medical history contra-indications

Poor oral hygiene

High caries rate

Periodontal disease

Large pulps

High possibility of further tooth loss within arch

Prognosis of abutment poor

Length of span too great

Ridge form and tissue loss

Tilting and rotation of teeth

Degree of restoration

Periapical status and perio

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What is meant by abutment

a tooth that serves as am attachement for a bridge

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What is meant by pontic

Artificial tooth which is suspended from abutment tooth

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What is meant by retainer in bridgework

The extracoronal or intracoronal restorations that are connected to the pontic and cemented to the prepared abutment teeth

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What is meant by coonectors

Component which connects the pontic to the retainer

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What is meant by Edentolous span

Space between teeth that is to be filled by a bridge or partial denture

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What is meant by saddle

Area of the edentolous ridge over which the pontic lies

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What is meant by pier

An abutment tooth which stands between and is supporting 2 pontics, with each pontic attached to a further abutment tooth

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What is meant by unit

Either a retaineer or pontic

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What is a fixed fixed bridge

A pontic with a retainer each end

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What is a cantilever bridge

Bridge with a retainer at 1 side of the pontic

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What is resin bonded bridgework (RBB) also known as

Adhesive bridgework
Min. prep. bridgework
Maryland bridge

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What are the adv of RBB

Minimal or no preparation

No anaesthetic needed

Less costly

Less surgery time

Can be used as a provisional restoration

If fails - usually less destructive than alternatives

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What are the dis-Adv of RBB

Rigorous clinical technique

Metal shine-through

Chipping pocelain

Can debond

High chance of it debonding again

Occlusal interferences
No trial period possible

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What are the indications for RBB

Young teeth (Less destructive)

Good enamel quality

Large abutment tooth surface area

Minimal occlusal load

Good for single tooth replacement

Simplify partial denture design

When would you not use RBB

Insufficent/poor quality enamel

long spans

Excess soft or hard tissue loss

Heavy occlusal force (bruxism)

Poorly aligned, tilted or spaced teeth

When planning bridges what would you mount it on

semi adjustable articulator

Whats important to check for Tx planning bridges

Dynamic occlusal relationships
-clinically
-mounted study models
-Consider wax ups

What are the 2 forms of RBB

Direct and Indirect

When are direct RBB best for

emergency situations

Whats happens in direct RBB

make a pontic
-Ideally patients own tooth
-Polycarbonate crown
- Cellulose matrix filled with composite

What is needed for indirect RBB

Generous palatal/lingual coverage good quality enamel keep supra gingival, 0.5mm

What is the best design for Ant. bridges

Cantilever

What is the best design for post. bridges

Fixed Fixed

Why cantilever bridges ant.

Divergent guidance paths

If required what is the prep for RBB

180 'wrap around' prep Rest seats supra gingival chamfer finish line 0.5mm remain in enamel

What does sandblasting do

micro-mechanical retention 50microns

When Tx planning a bridge what is the occlusal info you want

Incisal classification Canine-guided or group function Opposing tooth over-erupted Will bridge interfere with current occlusion Signs of parafunction present

What do you evaluate of potential abutments

Root configuration Angulation/rotation of abutment Periodontal health Surface area for bonding & quality of enamel Risk of pulpal damage Quality of endodontics: Re-root canal treatment Remaining tooth structure present

What are the considerations in pontic design

Cleanseability Apperance Strength

What are the different pontic designs

1. wash through 2. dome 3. modified ridge lap 4. Ridge lap 5. Ovate

What is the wash through pontic design

Makes no contact with soft tissue Functional rather than for appearance Consider in lower molar area

What is the dome shaped pontic design

Useful in lower incisor, premolar or upper molar areas Acceptable if occlusal 2/3 of buccal surface visible

What is modified ridge lap pontic design

Buccal surface looks as much like tooth as possible Lingual surface cut away Line contact with buccal of ridge Problems with food packing on lingual surface of ridge

What is ridge lap pontic design

Greatest contact with soft tissue If designed carefully: can be cleansed Less food packing than ridge-lap Care taken not to displace soft tissue or cause blanching of tissue

What materials are used for conventional bridges

All metal Metal ceramic All ceramic Ceromeric

When would gold be used

Lower post. area

What should you try to avoid and why

distal cantilevers Concern that occlusal forces on pontic will produce leverage forces on abutment tooth causing it to tilt

What cement is used for all metal conventional bridgework and metal ceramic

Aquacem (GI luting cement) RelyX luting (RMGI luting cement)

What cement is used for Adhesive bridge

panavia 21 (anerobic duel cure resin cement)

What cement is used for a all ceramic bridge

NEXUS (duel cure resin cement)