FIXED PROSTHODONTICS ( CROWN & BRIDGE ) DR.HANI SHAKIR.

DR.HANI SHAKIR

FIXED PROSTHODONTICS ( CROWN & BRIDGE )

DR.HANI SHAKIR

DEF. Art and science of restoring

damaged teeth with cast metal, metal-ceramic,

or all-ceramic restorations.

DR.HANI SHAKIR

Replacement and restoration of teeth by artificial substitutes that

are not readily removable from the

mouth.

Its focus is to restore function, esthetics, and comfort.

DR.HANI SHAKIR

RESTORATION1. Extracoronal :A. Full metal crown.

B. Partial crown.C. Veneer.

2. Intracoronal :A. Inlay.

B. Onlay.3. Intra and extracoronal :

Post and core

DR.HANI SHAKIR

DR.HANI SHAKIR

A crown :is a cemented extracoronal restoration

that covers, or veneers, the outer surface of the clinical crown. It

should reproduce the morphology and contours of the damaged coronal

portions of a tooth while performing itsfunction. It should also protect the

remaining tooth structure from further damage.

DR.HANI SHAKIR

DR.HANI SHAKIR

Full or complete veneer crown covers all of the clinical crown.

It may be fabricated from: metal (gold alloy)

ceramic veneer fused to metal(PFM), an all-ceramic

resin and metal resin only.

Partial veneer crown only portions of the clinical crown are

veneered

DR.HANI SHAKIR

DR.HANI SHAKIR

Fixed partial denture :( Bridge )

is a prosthetic appliance,permanently attached to remaining

teeth, which replacesone or more missing teeth

DR.HANI SHAKIR

DR.HANI SHAKIR

treatment canrange from the restoration of a

single tooth to therehabilitation of the entire

occlusion.

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Abutment: A tooth serving as an attachment for a fixed partial denture.

Pontic : The artificial tooth suspendedfrom the abutment teeth.

The pontic is connected to the fixed partial denture

retainers:extracoronal restorations that are cemented

to the prepared abutment teeth connectors:

connect pontic to retainer

DR.HANI SHAKIR

DR.HANI SHAKIR

Abutments

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Retainers

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Connectors

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Edentulous Ridge

DR.HANI SHAKIR

DR.HANI SHAKIR

Indications

One or two adjacent teeth are missing

in the same arch .

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1- when one or more teeth require removal or missing.

To restore appearance and maintain stable occlusion, esthetics and function.

2 - The supportive tissues are healthy. 3 - Whenever properly distributed and healthy

teeth exist to serve as Suitable abutment .4 – Prevention of the consequences of not

replacing missing tooth5 - The patient is in good health and wants to

have the prosthesis placed. 6 - The patient has the skills and motivation to

maintain good oral hygiene.

Diseases

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The consequences of removal without replacement:

Supra occlusion of the opposing tooth or teeth

Tilting of the adjacent teeth Loss of proximal contact Esthetics

DR.HANI SHAKIR

DR.HANI SHAKIR

Contraindications for Fixed Prosthodontics

Necessary supportive tissues are diseased or missing.

Suitable abutment teeth are not present. The patient is in poor health. The patient is not motivated to have the

prosthesis placed. The patient has poor oral hygiene habits. The patient cannot afford the treatment. The patient age.

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Advantage of replacing missing teeth

Appearance Ability to eat

Speech Periodontal splinting

A feeling of completeness Orthodontic retention

Restoring occlusal vertical dimension

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Disadvantage of replacing missing teeth

Damage to tooth and pulp

Secondary caries

Failures

Effects on the periodontium

Cost and discomfort

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Retainers

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Standard

Full Gold Crown

3/4 Gold Crown

7/8 Gold Crown

Porcelain Fused To Metal

Combination

3/4 Gold Crown

Facial wall unprepared Facial cusp minimally

reduced occlusally Grooves placed to

prevent lingual displacement of crown

Minimal facial extension interproximally

DR.HANI SHAKIR

DR.HANI SHAKIR

Non StandardImplantInlayOnlayCantileverAll CeramicPier AbutmentResin Bonded (“Maryland Bridge”)

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Types of Bridge Conventional

Adhesive

Hybrid

Bridge Design

Fixed-fixed

Fixed-moveable

Cantilever

Spring cantilever

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Fixed/fixed bridge

definition A prosthesis where the artificial tooth or teeth is supported rigidly on either side by one or more abutment teeth

( Rigid connector at both end of the pontic).

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Fixed/fixed bridge

Indications

Where missing units are

bound by abutment teeth

which are capable of

supporting the functional

load of the missing teeth.

Procedure The abutment teeth are

prepared with parallel

taper

DR.HANI SHAKIR

DR.HANI SHAKIR

Fixed/fixed bridge

Advantages

strong and retentive

It can be used

for single or multiple

missing units .

Disadvantages. requires the

preparation of the

abutment teeth to be

parallel

DR.HANI SHAKIR

DR.HANI SHAKIR

Fixed/movable bridge

A prosthesis where the artificial tooth or teeth is rigidly supported on one side, usually the distal end by one or more abutment teeth

( Rigid connector at one end, a movable connector at the other end)

DR.HANI SHAKIR

DR.HANI SHAKIR


Indications Where abutment teeth

are tilted or rotated in

relation to each

other The construction of

large units of

bridgework

Procedure Each abutment tooth

can be prepared

independently although

special consideration

should be given to the

placement of the movable

joint.

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Advantages

Divergent abutments

can be used

more conservative of

tooth structure.

The parts can be

cemented separately.

Disadvantages.

more demanding

of laboratory time

The construction of a

temporary bridge

difficult.

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GIVE THE NAME OF THE RESTORATION?

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Cantilever bridge

A prosthesis where the artificial tooth or teeth are supported on one side only by one or more abutment teeth

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Cantilever bridge

Indications Where the abutment

tooth can carry the occlusal load of the artificial tooth

where the occlusion

is protected against potentially damaging rotational forces.

Procedure A single tooth

preparation is carried out on to the

abutment tooth in a similar manner to a

conventional crown preparation.

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Cantilever bridge

Advantages

The most conservative

design

There is no problem of

paralleling abutment

teeth during

preparation.

Disadvantages.

The size of pontic is limited to

one or two units

I f a contact point from the

pontic to the neighboring tooth is

not placed then potentially

rotational forces could be

destructive to this type of design.

DR.HANI SHAKIR

DR.HANI SHAKIR

Spring cantilever bridge

A prosthesis where the artificial tooth is

Supported by a connecting bar to the abutment tooth or teeth.

DR.HANI SHAKIR


Indications This type of restoration

is placed where a patient has sound anterior teeth with one missing unit

where diastemas are present around an anterior missing unit.

Procedure Posterior teeth are

prepared for the

support of the anterior

missing unit.

DR.HANI SHAKIR

DR.HANI SHAKIR


Advantages Anterior teeth are not

involved. Diastemas can be preserved.

Disadvantages. Some patients find

the connecting palate uncomfortable.

The bar may distort if it is too thin or the

occlusion on the pontic is excessive.

FIXED PROSTHODONTICS ( CROWN & BRIDGE ) DR.HANI SHAKIR.

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