Bridgework 3 Flashcards
(46 cards)
What are tx options for missing teeth/severely broken down teeth?
Nothing
RPD
Bridge
Implants
When considering a bridge what must we think about?
Whole mouth - prognosis of pts other teeth - if we end up with large span of edentulous area is a denture more likely better tx option or implants?
What can we guarantee in restorative dentistry?
Every single restoration we place will fail (case of when rather than if - so must consider long term options for that patient and what we can replace it with once failure occurs)
What is the success rates for resin bonded bridges?
5 year - 80%
10 year - 80%
What are the success rates for cantilever bridges?
80% 10 years
What are success rates for fixed fixed bridges?
90% after 10 years
How do we get occlusal information if we are considering prep?
Impressions
mount study casts on semi-adjustable articulator
assess occlusion (incisal class, excursive movements - group or canine), over erupted teeth reducing inter-occlusal space, prafunction)
What do we look at in terms of the occlusion when planning bridgework?
Incisal classification
Movements in excursion - group or canine guidance
Over erupted teeth which reduce the inter occlusal space making it hard to place restoration
parafucntion signs - wear faces, attrition - bridgework may fail
changing occlusion
What are the incisal classifications?
class I - incisal edge of lower incisors lies on or directly beneath cingulum plateau of upper incisors
Class II Div I - incisal edge of lower incisors lies posterior to cingulum plateau of upper incisors and teeth are prolines
Class II Div II - incisal edge of lower incisor lies posterior to cingulum plateau of upper incisors and teeth are retroclined
Class III - incisal edge of lower insures lies anterior to cingulum plateau of upper inciors
What are signs of parafunction?
Wear facets, attrition etc
What must we decide in terms of bridge prep?
Minimal prep?
conventional prep?
How do we asses abutment tooth?
Look clinically at how much tooth tissue ether is
assess pulp - RCT? sensibility testing? assess RCT?
Perio condition - healthy or if perio disease is it inactive and stable?
roots - is root large, multicoated, Abel to withstand forces of missing teeth?
angulation/rotations of tooth?
perio health - if teeth mobile they can’t act as abutment teeth
Why can bridges fail?
Poor moisture control during cementation
Poor OH
Heavy occlusal forces
Unfavourable occlusion
trauma
parafunctional habits
What is risk of bridges in terms of difficulty cleaning?
Risk of caries or PD problems
Why do we have to assess enamel?
We want to bond to to high quality enamel - dentine has inferior chemical bond
When might enamel be hard to bond to ?
Amelogensis imperfecta
Before bridging a tooth what must we do with RCT?
Assess tx - do we need to re-root treat tooth - if we dont and tooth ends up with PA infection the bridge is waste of time
What are the types of bridges?
Adhesive - fixed fixed or cantilever
Conventional - fixed fixed or cantilever or fixed moveable
Hyriid
Spring cantilever bridge
What are the types of bridge poetics?
Sanitary/wash through pontic
Dome pontic
Modified ridge lap
Total ridge lap pontic
Ovate bridge pontic
What is aim of the pontic?
To restore appearance of the missing tooth and give pt additional occlusal surface in aim to restore function and stabilise the occlusion (inc masticatory function)
WHtat 3 things must we consider when making a pontic?
Aesthetics
Cleansability
Strength
What does cleansibility mean in terms of a bridge pontic?
The ability for this area to be clean - pontic must be SMOOTH, HIGHLY POLISHED OR GLAZED SURFACE to snare plaque doesn’t adhere to it inc risk of caries/PD
How should pontic look?
In anterior zone = tooth like
posterior zone = aesthetics less of problem and we can compromise for function rather than aesthetics
What happens to strength of bridge as length of span increases?
As length increases strength of bridge becomes weaker - we need greater strength towithsatnd occlusal forces so may need to make it thicker
