Updated Crown 5th Stage Crown and Bridge PDF

1 Prosthodontics (Prosthetic Dentistry or Prosthodontia) By Dr. Faisal Alhuwaizi  What We Studied in Previous Years What We Will Study This Year Lec.1 Introduction to fixed prosthesis. Lec.1 Prosthodontics Lec.2 Biomechanical Properties of Tooth Preparation. L...

1 Prosthodontics (Prosthetic Dentistry or Prosthodontia) By Dr. Faisal Alhuwaizi  What We Studied in Previous Years What We Will Study This Year Lec.1 Introduction to fixed prosthesis. Lec.1 Prosthodontics Lec.2 Biomechanical Properties of Tooth Preparation. Lec.2 Fixed Partial Denture (Bridge) Lec.3 Finishing Line of the Preparation. Lec.3 Evaluation of Abutment Lec.4 Full Metal Crown. Lec.4 Biomechanical Consideration Lec.5 Porcelain Fused To Metal. Lec.5 Bridge Retainers Lec.6 All Ceramic Crown. Lec.6 Pontic Lec.7 Partial Veneer Crown. Lec.8 Post Crown. Lec.7 Fluid Control & Soft Tissue Management. Lec.9 Impression for C&B. Lec.8 Impression Materials Lec.10 Final Impression. Lec.9 Interocclusal Record (Bite Registration) Lec.11 Working Cast and Die. Lec.10 Shade Selection P.1 Lec.12 Provisional Restoration. Lec.13 Waxing. Lec.10 Provisional (Temporary) Restorations P.2 Lec.14 Investing. Lec.11 Try in and Cementation Lec.15 Burnout & Casting. Lec.12 Adhesive Bridge Lec.16 Cleaning & Finishing. Lec.17 Try-in and Adjustment. Lec.13 Failure In Crown & Bridge Prosthodontics Lec.18 Crown Cementation Lec.14 Dental Ceramic 00  Prosthodontics The dental specialty is concerned with restoring & maintaining oral functions, comfort, appearance & health of the patients by making artificial replacements for missing parts of the mouth and jaw. 01  Branches of Prosthodontics Fixed Prosthodontics FPDs. Removable Prosthodontics. a) Complete Denture. b) Removable Partial Denture RPDs. Implant Prosthodontics. Maxillofacial Prosthodontics. 02  Fixed Prosthodontics It’s a branch of dental science that deals with restoring damaged teeth with artificial crown & replacing the missing natural teeth by a dental prosthesis permanently cemented in place (Fixed partial denture). Types of Fixed Prostheses Extra coronal Intra coronal It involves all restorations that seat over the It involves all restorations that seat inside the tooth such as all types of crown restorations (Full tooth such as inlay, onlays, pinlage. metal crown, partial crown, PFM, all ceramic crown) & direct or indirect veneer restoration. 03  The Crown It's a fixed extra coronal artificial restoration for the coronal portion of a natural tooth. It must restore morphology, function & the contour of the damaged portion of a tooth and must protect the remaining tooth structure from further damage. Types of Crowns (Classifications) a. According to the coverage area. Complete Crown / Partial Crowns / Complete Replacement b. According To Materials Used in The Construction Of C&B Restorations Metal Crowns / Non-Metal Crowns / Combination 04 The Crown A. According to the coverage area. 1 Complete crown: It covers the coronal portion of the tooth, such as full metal crown, All- ceramic crown (made of ceramic material). 2 Partial Crown: It is covers part of the coronal portion of the tooth such as 3/4 Crown, 7/8 Crown. 3 Complete replacement: it involves those that replace the natural crown entirely while retaining itself by means of a metal extended inside the root canal space of the tooth such as a post crown. 05 The Crown B. According To Materials Used in The Construction Of C&B Restorations 1 Metal Crowns: Gold alloy and its alternatives. 2 Non-metal crowns: Acrylic resin, Zirconium, or Porcelain as in jacket crown. 3 A combination: of metal and plastic materials as in PFM crown restorations. 06 Bridge It is a fixed dental prosthesis (appliance) which replaces and restores function and aesthetic of one or more missing natural teeth. It cannot be removed from the mouth by the patient and primarily supported by natural teeth or root. Components of The Bridge 1 Retainer It's the part that seat over (on or in) the abutment tooth connecting the pontic to the abutment. It is Pontic either a major or minor retainer, or it could be crown, Retainer inlay, post & core. 2 Pontic It is the suspended member of fixed partial denture that replaces the missing tooth or teeth, usually it occupies the position of the missing natural tooth. 07 Bridge 3 Connector It’s the part that joins the individual components of the bridge together (retainer& pontic), which could be a fixed (rigid) or movable (flexible) connector. When the retainer is attached to a fixed connector it's called a major retainer,but when it is attached to a flexible (movable) connector it is called a minor retainer. 08  Definitions (Terminology) 1. Abutment: A tooth to which a bridge is attached. 2. Span: Is the space between natural teeth that is to be filled by pontics. 3. Saddle: Is an area of the edentulous ridge over which the pontic lies. Pier Abutment 4. Pier: Is an abutment standing between two abutments & supporting two pontics, each pontic being attached to further abutment. 10  5 unit bridge 5. Unit: when applied to bridgework, means either a retainer or a pontic, thus a bridge that replaces a premolar using two abutments is 3 unit bridge referred as three Unit Bridge. 6. 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. 11 Why Do A Fixed Partial Denture? The stability of an individual tooth depends on a balance of the forces exerted on that tooth by the adjacent, opposing teeth, supporting tissue & the soft tissue of the cheek, lips & tongue. When a single tooth is not replaced (after loss), this balance is upset, & the consequence may by: 1. Super eruption of the opposing tooth or teeth a) Gingival recession. b) Traumatic occlusion or lacking bite. c) Loss of bony support for that tooth. d) Loss of the proximal contact. 13 2. Loss of function on the affected side a) Diffuse atrophy. b) Heavy deposition of plaque & leads to gingivitis & periodontal disease. c) Trauma to the soft tissue during function. d) Loss of tissue (contraction of both soft tissue & alveolar bone). 3. Tilting (drifting) of the adjacent teeth. 4. Loss of the proximal contact to: a) Food stagnation & pocketing. b) Sub-gingival caries. 5. Periodontal problem & mobility. 14 Posterior Bite Collapse The posterior teeth support the vertical height of the face. If they are lost, the face tends to lose height and close down; this is called “posterior bite collapse”. Figure 1: The back teeth and front Figure 2: The loss of the back Figure 3: Without replacement of teeth work in harmony. The back teeth place excessive pressure on the back teeth, the teeth start to teeth support facial height & chew the front teeth causing shifting of shift and excessive pressure food while the front teeth cut food, teeth and slight loss of facial causes the front teeth to spread protect the back teeth in lateral jaw height. forward. Loss of facial height movements and provide your smile. occurs. 15 The General Effects Of Tooth Loss 1) Generalized collapse of lower & upper dental arches. 2) Premature contact causing deviation in the normal movement of the mandible which might lead to TMJ dysfunction & muscle spasm that cause pain. 3) Tooth loss may lead to unilateral mastication on the opposite side of the dental arch which results in periodontal problems, caries on the affected side due to deficient mechanical cleaning afforded by the act of mastication. 4) Posterior bite collapse these changes also put pressure on the front teeth which tend to move or splay forward. 16 The General Effects Of Tooth Loss Treatment at this stage prevents further disruption, it may be insufficient to ration back to full health, it need extended treatment plans including, ortho. Treatment, additional cast restoration to correct the disturbed occlusal plane. Reasons For Treating Tooth Loss 1) Aesthetic. 2) Function (ability to eat). 3) Pain due to TMJ dysfunction & muscle spasm. 4) Maintenance of dental arch (occlusal stabilization & prevent tilting). 5) Speech (particularly lower incisors). 17 Methods Of Treating Tooth Loss ▪ Orthodontic. ▪ Removable partial denture. ▪ Fixed partial denture (tooth supported partial denture). ▪ Implant (Osseo-integrated implant). ▪ Combination. In some case the decision might be no prosthetic treatment 1. Long standing edentulous space (long span) into which there has been little or no drifting or elongation of the adjacent teeth. 2. Lack of distal abutment. 3. If the patients perceives no functional, occlusal or aesthetic impairment. 18