Prosthodontics Lecture 1

Study Notes

Prosthodontics is a dental specialty that focuses on restoring and maintaining oral functions, comfort, appearance, and health of patients by creating artificial replacements for missing parts of the mouth and jaw.

Deals with restoring damaged teeth with artificial crowns and replacing missing natural teeth with a dental prosthesis permanently cemented in place (Fixed Partial Denture)
Types of Fixed Prostheses
- Extracoronal: restorations that seat over the tooth (e.g., crown restorations, direct/indirect veneer restoration)
- Intracoronal: restorations that seat inside the tooth (e.g., inlay, onlay, pinlage)

A fixed extracoronal artificial restoration for the coronal portion of a natural tooth
Must restore morphology, function, and contour of the damaged portion of a tooth and protect the remaining tooth structure from further damage
Classifications
- According to coverage area
  - Complete crown: covers the coronal portion of the tooth (e.g., full metal crown, all-ceramic crown)
  - Partial crown: covers part of the coronal portion of the tooth (e.g., 3/4 crown, 7/8 crown)
  - Complete replacement: replaces the natural crown entirely (e.g., post crown)
- According to materials used
  - Metal crowns (e.g., gold alloy and its alternatives)
  - Non-metal crowns (e.g., acrylic resin, zirconium, porcelain as in jacket crown)
  - Combination of metal and plastic materials (e.g., PFM crown restorations)

A fixed dental prosthesis that replaces and restores function and aesthetics of one or more missing natural teeth
Components
- Retainer: the part that seats over (or in) the abutment tooth, connecting the pontic to the abutment (can be major or minor retainer, crown, inlay, post & core)
- Pontic: the suspended member that replaces the missing tooth or teeth, occupying the position of the missing natural tooth
- Connector: the part that joins the individual components of the bridge together (retainer & pontics), can be fixed (rigid) or movable (flexible)

Abutment: a tooth to which a bridge is attached
Span: the space between natural teeth that is to be filled by pontics
Saddle: the area of the edentulous ridge over which the pontic lies
Pier: an abutment standing between two abutments & supporting two pontics, each pontic being attached to a further abutment
Unit: Pontic + Retainer, when applied to bridgework, means either a retainer or a pontic
Path of Insertion: an imaginary line along which the restoration can be inserted and removed without any interferences or causing lateral force on the abutment

To maintain the balance of forces exerted on individual teeth
Consequences of not replacing a single tooth:
- Super eruption of the opposing tooth or teeth
- Gingival recession
- Traumatic occlusion or lacking of bite
- Loss of bony support for that tooth
- Loss of the proximal contact
To prevent:
- Loss of function on the affected side
- Tilting (drifting) of the adjacent teeth
- Periodontal problem & mobility

The loss of posterior teeth causing the face to lose height and close down
Effects:
- Generalized collapse of lower & upper dental arches
- Premature contact causing deviation in the normal movement of the mandible, leading to TMJ dysfunction & muscle spasm
- Tooth loss leading to unilateral mastication on the opposite side of the dental arch, resulting in periodontal problems, caries on the affected side
- Posterior bite collapse putting pressure on the front teeth, causing them to move or splay forward

Generalized collapse of lower & upper dental arches
Premature contact causing deviation in the normal movement of the mandible, leading to TMJ dysfunction & muscle spasm
Tooth loss leading to unilateral mastication on the opposite side of the dental arch, resulting in periodontal problems, caries on the affected side
Posterior bite collapse putting pressure on the front teeth, causing them to move or splay forward