FIXED PROSTHODONTICS ( CROWN & BRIDGE )

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Presentation transcript:

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

RESTORATION 1. Extracoronal : A. Full metal crown. B. Partial crown. C 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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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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Full or complete veneer crown covers all of the clinical crown 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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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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treatment can range from the restoration of a single tooth to the rehabilitation of the entire occlusion. DR.HANI SHAKIR

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

DR.HANI SHAKIR

Abutments DR.HANI SHAKIR

Retainers DR.HANI SHAKIR

Connectors DR.HANI SHAKIR

Edentulous Ridge DR.HANI SHAKIR

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

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 Diseases: mentally and physically compromised patient. Epilepsy. DR.HANI SHAKIR

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

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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. DR.HANI SHAKIR

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

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

Retainers DR.HANI SHAKIR

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

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

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

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

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.) DR.HANI SHAKIR

Fixed/fixed bridge Indications Procedure 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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Fixed/fixed bridge Advantages Disadvantages. 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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DR.HANI SHAKIR

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

Fixed/movable bridge Indications Procedure 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

Divergent abutments can be used 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

GIVE THE NAME OF THE RESTORATION? DR.HANI SHAKIR

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

Cantilever bridge Indications Procedure 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. DR.HANI SHAKIR

The most conservative design 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

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

DR.HANI SHAKIR

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