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Prosthodontics > Bridgework > Flashcards

Bridgework Flashcards

1
Q

what is the most common type of bridgework?

A

resin bonded (adhesive)

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2
Q

give 4 reasons for replacing missing dentition

A

-aesthetics
-function
-speech
-maintenance of dental health

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3
Q

what is a bridge?

A

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

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4
Q

list 6 general indications for bridgework

A

-function and stability
-appearance
-speech
-psychological reasons
-systemic diseases e.g. epilepsy
- co-operative pts

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5
Q

list 4 local indications for bridgework

A

-big teeth
-heavily restored teeth (conventional)
-favourable abutment angulations
-favourable occlusion

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6
Q

list 6 general contraindications for bridgework

A

-unco-operative pt
-medical history e.g. metal allergy
-poor OH
-high caries rate
-perio
-large pulps (conventional)

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7
Q

list 8 local contraindications for bridgework

A

-further tooth loss in arch likely
-poor prognosis of abutment
-length of span too great
-ridge form and tissue loss
-tilted/rotated abutment
-degree of rest. required
-periapical status
-periodontal status

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8
Q

define abutment

A

a tooth which serves s an attachment for a bridge

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9
Q

define Pontic

A

the artificial tooth which is suspended from the abutment teeth/tooth

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10
Q

define ‘retainer’

A

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

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11
Q

define ‘connectors’

A

component which connects the Pontic to the retainers

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12
Q

define edentulous space

A

space between natural teeth that is to be filled by a prosthesis

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13
Q

define ‘saddle’

A

area of edentulous ridge over which the Pontic will lie

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14
Q

define ‘pier’

A

an abutment tooth which stands between and is supporting two pontics
each Pontic is attached to a further abutment tooth

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15
Q

define ‘unit’

A

either a retainer or a Pontic
e.g.
a bridge with two retainers and one pontic= 3 unit bridge

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16
Q

what is a fixed-fixed bridge?

A

has a retainer at each end with a Pontic in the middle
joined by rigid connectors

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17
Q

what is a cantilever bridge?

A

has a retainer(s) at one side of the Pontic only

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18
Q

give 6 advantages of adhesive cantilever bridges

A

-minimal or no prep
-no anaesthetic needed
-less costly
-less surgery time
-can be used as a provisional for implant in kids
-less destructive in failure

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19
Q

what is the wing of an adhesive cantilever bridge made of?

A

can either be ceramic or CoCr (more common)

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20
Q

if a pt has a high occlusal concept point, how long will this take to resolve?

A

10-14 days

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21
Q

give 6 disadvantages of adhesive cantilever bridges

A

-requires good moisture control
-metal shine through
-chipping porcelain
-debonding (first bond is best)
-occlusal interferences
-no trial period possible

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22
Q

give 5 indications for adhesive cantilever bridgework

A
  • young teeth
    -good enamel quality
    -large abutment tooth surface area
    -minimal occlusal load
    -good single tooth design
23
Q

give 6 contraindications of for adhesive cantilever bridgework

A

-insufficient or poor enamel quality
-long spans; likely to flex on occlusion
-excess soft or hard tissue loss
-heavy occlusal force e.g. bruxism
-poorly aligned, tilted or spaced teeth
-contact sports (will get away w mouth guard)

24
Q

Give 2 examples of when you would use direct resin bonded bridgework

A

-when the tooth needs to be extracted immediately
-if a tooth is lost traumatically

25
Q

What is commonly used as the Pontic in direct resin bonded bridgework? Give 4 examples

A

Patients own tooth
Acrylic denture tooth
Polycarbonate crown
Cellulose matrix filled with composite

26
Q

Why should the wing of an indirect resin bonded bridge be kept 0.5mm supragingival?

A

For cleaning

27
Q

Why is a fixed-fixed indirect bonded bridge rarely used?

A

One wing usually rebinds and becomes a bacterial ingress

28
Q

What type of patient is a fixed-fixed indirect bonded bridge useful for?

A

Post-Ortho patient

29
Q

For indirect bonded bridgework, where in the mouth would fixed-fixed and cantilever design both be placed?

A

Anterior- cantilever
Posterior fixed-fixed

30
Q

Why are cantilever indirect bridgework more successful anteriorly?

A

The longitudinal axis of anteriors are all different, meaning occlusal forces are directed down the teeth in different ways. The restoration would therefore get moved about in 2 different directions

31
Q

Why should you consider replacing a composite restoration on an abutment tooth before placing bridgework?

A

You will get a better bind to new composite

32
Q

Why should you consider replacing an amalgam restoration on an abutment tooth with composite before placing bridgework?

A

Amalgam will have a compromised bond to chemically cured composite cement

33
Q

Why should the prep for bridgework ideally remain in the enamel?

A

For a better bond

34
Q

How thick is a metal retainer wing for a cantilever bridge?

A

0.7mm

35
Q

How deep should posterior occlusal rest seats be when placing a cantilever bridge?

A

2mm

36
Q

How do you prep the fit surface of a CoCr bridgework retainer?

A

-sandblast for micro-mechanical retention
-aluminium oxide 50microns- creates indentations

37
Q

What do you use to cement a bridge?

A

Chemically/dual cure composite outing cement e.g. Panavia21

38
Q

What do you do after removing excess cement when placing a bridge?

A

Place an oxygen inhibitor (e.g. Oxyguard II) around the cement margins and then wash off

39
Q

What do you use to etch prior to placing a bridge?

A

37% Ortho-phosphoric acid

40
Q

What checks should you make after placing a bridge?

A

-check occlusion- there should be no excessive forces placed on Pontic
-check the pt can adequately clean around the Pontic

41
Q

What is a hybrid bridge?

A

A bridge with a fixed retainer and an adhesive retainer

42
Q

What types of patients are suitable for fixed-fixed bridges anteriorly?

A

-class 2 occlusion
-anterior open bite

43
Q

Name 5 advantages of fixed-fixed bridgework

A

-robust design
-maximum retention and strength
-abutment teeth splinted together
-can be used in longer spans
-lab construction striaghtfirward

44
Q

Name 4 disadvantages of fixed-fixed bridgework

A

-preparation must be parallel
-prep must be tapered 5-7o or crown can slide off
-common oath of insertion for abutments
-removal of tooth tissue means danger to pulp

45
Q

Give 3 advantages if cantilever bridgework

A

-conservative design
-lab construction straight forward
-no need to ensure multiple tooth preps are parallel

46
Q

Name 3 disadvantages of cantilever bridge work

A

-short span only
-rigid to avoid distortion (more prone to fracture)
-medial cantilever preferredas pt more likely to occlude on posterior teeth first

47
Q

What are fixed moveable bridges used to overcome?

A

Abutment teeth not being parallel

48
Q

Why are fixed moveable bridges named this?

A

It will flex when the pt occludes

49
Q

Name 5 advantages of fixed moveable bridgework

A
  • prep doesn’t require a common path of insertion, can be more conservative
    -each prep design to be retentive independent if others
    -more conservation of tooth tissue
    -allows minor tooth movements
    -may be cemented in 2 parts
50
Q

Name 4 disadvantages of fixed moveable bridgework

A

-length of span is limited
-lab construction is more complicated
-possible difficulty in cleaning beneath moveable joint
-can’t construct provisional bridge

51
Q

What is a spring cantilever bridge?

A

One Pontic attached to end of metal arm that runs across the palate to a rigid connector on the palatal side of a retainer

52
Q

Name 2 advantages of spring cantilever bridgework

A

-useful if spacing present between upper incisors
Good when posterior tooth is a more suitable abutment

53
Q

Name 5 disadvantages of spring cantilever bridgework

A

-can only be used to replace upper teeth
-difficult to clean beneath palatal connector
-may irritate he paltalmucosa
-difficult to control movement of Pontic due to springiness of metal atm/displacement of palatal soft tissues
-mucositis and inflammation usually seen direct,y behind the connector

54
Q

What criteria must a tooth make to be suitable as an abutment?

A

-be able to withstand the forces previously directed to the missing teeth
-supporting tissues should be healthy and free of inflammation
-length of tooth coronal to alveolar crest compared to length of root embedded in bone (optimum 2:3) (minimum 1:1)

Prosthodontics (8 decks)

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