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FIXED PROSTHODONTICS ( CROWN & BRIDGE )
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DEF. Art and science of restoring
damaged teeth with cast metal, metal-ceramic,
or all-ceramic restorations.
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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.
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RESTORATION1. Extracoronal :A. Full metal crown.
B. Partial crown.C. Veneer.
2. Intracoronal :A. Inlay.
B. Onlay.3. Intra and extracoronal :
Post and core
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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.
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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
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Fixed partial denture :( Bridge )
is a prosthetic appliance,permanently attached to remaining
teeth, which replacesone or more missing teeth
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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
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Abutments
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Retainers
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Connectors
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Edentulous Ridge
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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
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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
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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
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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
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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)
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Fixed/movable bridge
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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Fixed/movable bridge
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.
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Spring cantilever bridge
A prosthesis where the artificial tooth is
Supported by a connecting bar to the abutment tooth or teeth.
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Spring cantilever bridge
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.
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Spring cantilever bridge
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.
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