Introduction-To-Fixed-Prosthodontics. 2nd year 2024.ppt

Introduction to Fixed Prosthodontics By Akhlas Elsarah Terminology Restorative Dentistry Operative Dentistry Fixed Prosthodontics Esthetic Dentistry Prosthodontics Dentistry Fixed Prosthodontics Removable Prosthodontics Implant Maxillofacial Pros...

Introduction to Fixed Prosthodontics By Akhlas Elsarah Terminology Restorative Dentistry Operative Dentistry Fixed Prosthodontics Esthetic Dentistry Prosthodontics Dentistry Fixed Prosthodontics Removable Prosthodontics Implant Maxillofacial Prosthesis  A Prosthesis: Is any artificial replacement of a missing body part Prosthodontics: Is the Restoration of oral function, comfort, appearance & health by restoring natural teeth & replacing missing teeth & contiguous oral & maxillofacial tissues with artificial substitutes. Fixed prosthodontics Is a branch of prosthodontics concerned with the replacement and restoration of teeth by artificial substitutes that are not readily removable from the mouth. The scope of fixed prosth. range from: The Restoration of a single tooth to occlusal rehabilitation. The treatment of TMJ & neuromuscular problems. 1.Restore function and mastication. 2.Restore esthetics. 3.Maintain the health and integrity of dental arch. 4.Treat problems related to TMJ.  Crown: is an extra coronal restoration that covers, or veneers, the outer surface of the clinical crown. It should reproduce the morphology of the damaged portions of a tooth and its function. it can be made of metal or combination of metal and porcelain or only porcelain Complete veneer crowns : Restore all surfaces of the clinical crown. The restoration material may be: Metal crown metal-ceramic crown all ceramic crown  Indications for Fixed Prosthodontics  One or two adjacent teeth are missing in the same arch.  The supportive tissues are healthy.  Suitable abutment teeth are present.  The patient is in good health and wants to have the prosthesis placed.  The patient has the skills and motivation to maintain good oral hygiene.  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. Casting/Crown Fabrication 1. Tooth Preparation, Including Caries Removal & Build-Up 2. Temporization (Ready before impression) 3. Impression 4. Model (Cast) and Die Fabrication 5. Wax-Up (Exact shape & size of desired crown) 6. Investing and Casting 7. Crown Adjusting and Polishing 8. Clinical Try-In and Cementation  Crown There are four types of crown which are; Anatomic crown Clinical crown Artificial crown Temporary crown Consequences of tooth loss without replacements Super eruption of opposing tooth or teeth. Tilting of adjacent tooth or teeth. Loss of proximal contact and food impaction. Loss of bone. Esthetic Speech Mastication  Classification of fixed prosthodontics Single restoration (Crown) Fixed partial denture (FPD) Splint: It is a restoration designed for therapeutic reason. Combination.  Options for teeth replacement Implant. Resin bonded bridge. Fixed partial denture. Removable partial denture.  fixed prosthodontics can be divided into Extra coronal restoration Intracoronal restoration Inlay Onlay According to surface coverage Full coverage Partial coverage Inter radicular restoration Extra coronal restoration (classification of crown, retainers) Based to number of surface coverage A. Full coverage B. Partial coverage 5 Surfaces are coverage Less than 5 surfaces are coverge Based on the materials 1. Metal 2. Non metal porcelain or ceramic 3. Combinations Jacket crown Based on retentions 1.By grooves 2.BY pins 3.Modified type grooves and pins  Partial coverage Restore only a portion of clinical crown. Classifications : According to retionions 1. By grooves: a Three quarter crown (3/4) Reverse three quarter crown(R 3/4) Half crown (1/2) seven-eight crown 7/8 2. By pins Pinledge retainers. 3. Modified type:(grooves + pins )  Three-quarter crowns: Restore the occlusal and three of the four axial surface Not including the facial surface. everse three-quarter crown :Restore all surface except the lingual surface  Seven-eight crown: Are extension of the three-quarter crown to include the facial Surface. The preparation is same As ¾ crown in addition to the distal side of the facial Surface included in the preparation All surfaces except for mesiobccal surface. Proximal-half crown: Restore the occlusal and mesial surface, as well as portio of the facial and lingual surface. Pinledge retainer: Preparation to obtain primary retention and resistance from long parallel pins in The lingual or palatal surfaces of the clinical crown. Laminate veneer :Are veneer restoration that restore the facial surface of a tooth for esthetic purpose. They are fabricated from resin or porcelain , they bond to etched enamel with composite resin luting agent. Resin-Bonded restorations: It is a conservative bridge with minimum preparation only on enamel and retained on the teeth by wings that are bonded to etched enamel. also called (Adhesive bridge). Inlay Retainer: It is a classic intracoronal cast restoration that restores the proximal and occlusal surfaces but does not protect or cover the cusp entirely. Onlays Retainer: Is a modification of the inlay with cusp overlays on the occlusal Surface to protect the integrity of the remaining tooth structure. Radicular Retained restorations : consist of a post or dowel with an attached core that obtains its retention and resistance to displacement from the prepared root portion of endodontically treated tooth. Components of post crown; 1.Post. 2.Core 3.Extra coronal crown is a prosthetic appliance, permanently attached to remaining teeth, which replaces one or more missing teeth. components of this restoration are : A tooth serving as an attachment for a fixed partial denture is called an abutment. The artificial tooth suspended from the abutment teeth is a pontic. The pontic is connected to the fixed partial denture retainers, which are extracoronal restorations that are cemented to the prepared abutment teeth. Components of bridge: 1-pontic : part of bridge replace the missing tooth or teeth 2-retainer :part of bridge attach cemented over the prepared teeth to fix the bridge 3-connector:part of bridge the uniting the pontic with retainer. The connector two types : Rigid (soldered type joint) Non rigid: Broken-stress or occlusal rest Component of a fixed partial denture  BRIDGES 1-According to retention A-Tooth supported fixed partial denture (conventional bridge) 1-simple bridge: a-fixed-fixed bridge b-fixed-movable bridge c-cantilever bridge d-spring bridge 2-compound bridge. B-Implant supported fixed partial denture. 2-According to site 1-anterior 2-posterior 3- Complex 2-According to material a-Metallic 1-precious alloy 2-non-precious alloy b-Combined 1-metallic with labial or buccal porcelain or acrylic 2-metallic with full coverage porcelain or acrylic c-Non-metallic 1-all porcelain 2-all acrylic 3. According to chronology Provional restoration. Temporary Definitive restoration. Final 4. According to length of span Short span one tooth missing. Medium span two teeth missing. Long span more than two teeth missing. 2-According to site 1-anterior bridge: It is abridge which extends only between anterior teeth ( from one canine to other canine) Unilateral: does not cross midline. Bilateral: involve teeth on both side of the midline. 2-posterior bridge: It is abridge which extends only between posterior teeth. All are Unilateral. 3- Complex bridge: It is abridge which extends from anterior segment of dental arch to the posterior segment passing by canine area.  According to retention : Simple bridge : Fixed- Fixed-movable. fixed. Spring Cantilev cantilever. er.  Removable.  Compound bridge :  Employing more than one of the above types. P rof.D r.B adawy Fixed-fixed bridge: Is a bridge where the abutment and the pontic are soldered Together and the bridge is cemented at both ends to the abutment teeth. Fixed-movable bridge: Is a bridge where one retainer is soldered to pontic and The other retainer consist of two parts (key and key way) one is attached to pontic and the other is attached to retainer that allow some movement. Removable Bridge: (precision Attachment Bridge) (Removable partial denture with Internal attachment). Is a bridge where each retainer consists of two parts, one fixed to the abutment tooth, and one soldered to the pontic and the bridge can be Removed by the patient for cleansing purposes. Cantilever Bridge:(Free end bridge) is a bridge where the pontic is fixed to and derives is support from one or double retainers at one end only while the other End is unsupported. Spring cantilever Bridge: Is a cantilever bridge where the pontic is at the end of slightly resilient curved arm deriving its support from an abutment remote fromThe edentulous space. Compound Bridge: Is a combination type bridge composed of two or more of the Simple types. Complex Bridge: Is a bridge that extends at one of its terminals beyond the canine. Temporary Bridge : Is a bridge made and use temporarily for the protection of The prepared teeth and maintenance of the space till completion and cementation of the bridge. Spring bridge temporary bridge.  Primary abutment: which adjacent to the primary to edentulous space.  Secondary abutment: which support the primary abutment.  Pier Abutment: Isolated abutment between two edentulous spaces  Distal Abutment: The last abutment distally. Primary Abutment Secondary Abutment  Natural Tooth:  Full tooth Crown, root  Remaing root.  Implant: is a device which is surgically  placed into the jaw bones to replace a single  tooth or teeth.  a pontic: is an artificial tooth on a fixed partial denture that replaces the missing natural tooth, restores its function and usually fills the space previously occupied by the natural crown. Pontics are classified  According to material  All metal ,All ceramic, Combination PFM  According to the ridge relation : with mucosal contact Without mucosal contact  Pontics with mucosal contact:  Pontics that are placed in contact with the mucosa are of different types. They include  Ridge lap or saddle pontic:  These pontics overlap the buccal and lingual surfaces of the ridge. They form a large concave contact with the ridge.  Modified ridge lap pontic:  The pontic does not contact the lingual aspect of the ridge, while contact the ridge labially.  Ovate pontic: is the most esthetic design. This appears as if the pontic is emerging from the ridge.  Conical pontic: They are also called as egg shaped pontic. They have a single point contact with the ridge.  Sanitary/hygienic pontic:  This design is called so due to its ease of cleaning as they do not touch the residual ridge.  Modified sanitary pontic:  This design gives more strength to the connectors with space for easier cleansing. is that part of the Br. Uniting the pontic with retainer joining the component parts of the Br. Types Of Connectors I. Rigid connectors II. Nonrigid connectors Porcelain Veneers & Fixed Partial Denture Fixed Partial Denture Porcelain is baked over a cast metal framework  Fixed Partial Denture (PFM) Metal framework for strength & porcelain for