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

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Presentation on theme: "FIXED PROSTHODONTICS ( CROWN & BRIDGE ) DR.HANI SHAKIR."— Presentation transcript:

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

2 DEF. Art and science of restoring damaged teeth with cast metal, metal-ceramic, or all-ceramic restorations. DR.HANI SHAKIR

3 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

4 RESTORATION 1. 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

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8 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 its function. It should also protect the remaining tooth structure from further damage. DR.HANI SHAKIR

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12 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

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27 Fixed partial denture : ( Bridge ) is a prosthetic appliance, permanently attached to remaining teeth, which replaces one or more missing teeth DR.HANI SHAKIR

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33 treatment can range from the restoration of a single tooth to the rehabilitation of the entire occlusion. DR.HANI SHAKIR

34 Abutment: A tooth serving as an attachment for a fixed partial denture. Pontic : The artificial tooth suspended from 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

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36 Abutments

37 Retainers

38 Connectors

39 Edentulous Ridge DR.HANI SHAKIR

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55 Indications One or two adjacent teeth are missing in the same arch. DR.HANI SHAKIR

56 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 tooth 5 - 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 DR.HANI SHAKIR

57 The consequences of removal without replacement: Supra occlusion of the opposing tooth or teeth Supra occlusion of the opposing tooth or teeth Tilting of the adjacent teeth Tilting of the adjacent teeth Loss of proximal contact Loss of proximal contact Esthetics Esthetics DR.HANI SHAKIR

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60 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. DR.HANI SHAKIR

61 Advantage of replacing missing teeth  Appearance  Ability to eat  Speech  Periodontal splinting  A feeling of completeness  Orthodontic retention  Restoring occlusal vertical dimension DR.HANI SHAKIR

62 Disadvantage of replacing missing teeth  Damage to tooth and pulp  Secondary caries  Failures  Effects on the periodontium  Cost and discomfort DR.HANI SHAKIR

63 Retainers

64  Standard Full Gold Crown 3/4 Gold Crown 7/8 Gold Crown Porcelain Fused To Metal Combination DR.HANI SHAKIR

65 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

66  Non Standard Implant Inlay Onlay Cantilever All Ceramic Pier Abutment Resin Bonded (“Maryland Bridge”) DR.HANI SHAKIR

67 Types of Bridge Conventional Conventional Adhesive Adhesive Hybrid Hybrid Bridge Design Bridge Design Fixed-fixed Fixed-fixed Fixed-moveable Fixed-moveable Cantilever Cantilever Spring cantilever Spring cantilever DR.HANI SHAKIR

68 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.) ( Rigid connector at both end of the pontic.) DR.HANI SHAKIR

69 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

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71 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

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74 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) ( Rigid connector at one end, a movable connector at the other end) DR.HANI SHAKIR

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76 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. DR.HANI SHAKIR

77 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. DR.HANI SHAKIR

78 GIVE THE NAME OF THE RESTORATION? DR.HANI SHAKIR

79 Cantilever bridge A prosthesis where the artificial tooth or teeth are supported on one side only by one or more abutment teeth DR.HANI SHAKIR

80 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  conventional crown preparation. DR.HANI SHAKIR

81 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

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83 Spring cantilever bridge A prosthesis where the artificial tooth is Supported by a connecting bar to the abutment tooth or teeth. DR.HANI SHAKIR

84 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. DR.HANI SHAKIR

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86 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. DR.HANI SHAKIR


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