Fixed Prosthodontics Introduction

Prosthodontics

• Branch of dentistry concerned with replacing teeth and contiguous tissues or jaw structures by artificial devices to restore oral function, comfort, appearance, and health of the patient
• Has three main branches: removable, fixed, and maxillofacial prosthesis

Fixed Prosthodontics

• Branch of prosthodontics concerned with replacing and/or restoring teeth by artificial substitutes (cast prosthesis) that cannot be removed by the patient
• Technique used to fabricate a fixed prosthodontic appliance securely fixed to natural tooth/teeth or screwed to one or more dental implants/implant abutments to restore teeth function and esthetics

Aims of Fixed Prosthodontics

• Restore function of teeth; mastication and speech
• Restore esthetics
• Maintain oral health and integrity

Indications for Fixed Prosthodontics

• Badly broken down teeth
• Primary trauma
• Tooth wear
• Hypoplastic conditions (congenital or acquired)

Contraindications for Fixed Prosthodontics

• No absolute contraindication, but consider:
  • When a more conservative approach can provide satisfactory results
  • Patient's age and medical condition (e.g. young patients below 18, elderly and medically compromised patients)
  • Patients with bad oral hygiene

Types of Cast Restorations

• Crowns (partial or full coverage)
• Bridges
• Inlays
• Onlays
• Veneers

Crowns

• Restores missing tooth structure of three or more axial surfaces and the occlusal/incisal surface of a tooth with a material such as cast metal alloy, ceramics, resin, or a combination of materials
• Anatomical crown: highest/topmost part of a tooth occlusal to the cementoenamel junction
• Clinical crown: part of the tooth that is visible in the mouth
• Dental crown: artificial replacement that restores missing tooth structure by surrounding part or all of the remaining structure with a material

Bridge

• Also called fixed partial dentures
• Dental prosthesis that is luted, screwed, or mechanically attached to natural teeth, tooth roots, and/or dental implants/abutments that provide primary support for dental prosthesis and restoring teeth in partially edentulous arch
• Consists of three components: retainer, pontic, and connector

Inlay and Onlay

• Inlay: fixed intracoronal restoration, a dental restoration made outside of the tooth to correspond to the form of the prepared cavity
• Onlay: fixed partial coverage restoration that restores one or more cusps and adjoining occlusal surfaces or the entire occlusal surface and is retained by mechanical or adhesive means

Veneer

• Thin lamination, shell-like dental material bonded to one side of the tooth to improve its appearance and/or restore its normal contour

Classification of Fixed Restorations

• According to retention:
  • Extracoronal restorations
  • Intracoronal restorations
  • Intraradicular restorations
• Extracoronal restorations:
  • Full coverage restorations
  • Partial coverage restorations
• Intracoronal restorations:
  • Inlays
  • Onlays
• Intraradicular restorations:
  • Post-retained restorations
  • Implants
• According to material used:
  • Ceramic restorations
  • Metal-ceramic restorations
  • Full metal restorations
  • Resin restorations
• According to position:
  • Anterior restorations
  • Posterior restorations
• According to time:
  • Temporary restorations
  • Permanent restorations