Beruflich Dokumente
Kultur Dokumente
Configurations of FPDs
Abutment Evaluation
Why do we need to evaluate abutment when we plan for FPD /
RPD ?
The idea is it support the prostheses then it will carry the hole
load .
It's all retained load + the new load of the missing teeth . when
extract the teeth and we do replacement , the abutment teeth
carry the load of itself + the missing teeth . so we need to
evaluate the abutment before fabricate our prostheses .
■ Pulpal assessment :
In fixed prosthodontic always vital teeth are preferable . it
could be nonvital , if it's non vital and it's endo treated it must
be properly evaluated . so either vital or proper endo treated
teeth , this endo treated teeth should not support more than 3
unit bridge . if we have upper right 6 pulpal treated and we
have missing 5 and 4 then the 6 is a pulpate abutment to carry
the load from the canine to 6 you can't use it to carry 4 unit
bridge . so endo treated teeth the guideline to use it when we
have 3 unit bridge OK . 3 unit bridge is the max extension of
the bridge to use it if have endo treated teeth as abutment . in
between either we have vital or endo treated teeth some time
you could have pulpal – capping . this pulp-capped teeth are
not not advised to be used as abutment it's contraindication .
the reason is 8 % of sound abutment after preparation within
10 years they will be pulpal involved ( periapical infection ,
pulpitis , whatever ) this mean pulp-capped teeth have high
risk … clear
The more load from the crown-root ratio the less load you
need , the need load with acrylic prostheses more than cobalt
crom and the reason the cobalt crom supported by teeth .
■ Root configuration :
- Triangular root better than round ones .
The more irregular structure inside alveolar bone the better
the resistance because more irregularity it's more surface area
more periodontal ligament area more resistance .
- Multi-rooted are better than single-rooted .
- Widely spaced roots are preferable .
If you have upper 6 the root separate from each other better
from fused root because the surface area become bigger .
- irregular roots are better .
that's mean curved lateral incisor better than typical lateral
incisor .
Slide 3-page 2
Again this is Ante's law if you follow Ante's law first ex it's
OK , second picture OK we are within the limit because the
first premolar almost the same size of the second premolar
and the second molar less then first molar we are a broaching
the border . the same case no way to fabricate the bridge
according to Ante's law , but if you have opposing partial
denture if you have good crown-root ratio if you have good
periodontal health then I can discharge the Ante's law and
fabricate my prostheses .
Biomechanical considerations
- bending and deflection of bridges .
- Dislodging forces on FPD .
- Primary and secondary abutment .
- Arch curvature and torque movements .
Slide5-page 2
Beam theory is the deflection of the structure under load .
If you have a solid structure mounted between two points and
apply a load in the middle of that structure this structure , the
longer structure the more deflection , the thicker structure the
less deflection . the relation is cubic .
Special problems
Slide 3-page 3
1- Pier Abutments ( ) الوسيط
It's a lone freestanding tooth with edentulous spaces on both
sides .
If you have pier abutments and you have missing teeth on
both side and you have replacement , who is know how much
the physiological movement of teeth in the socket ?
The max 108 micron could move buccolingual . this
movement is not fixed on each tooth , the anterior move more
than posterior . in this bridge the 7 will move less than canine
and the 5 will be in between if you joint deferent structure
together and they move in deferent level .
Slide 5- page 3
2- Tilted molar abutment :
The most common scenario when you loss the lower 6 the 7
usually move forward . you have to have a common path of
insertion parallel . this is can corrected during preparation .
the problem where in the mesial structure of the 7 , and you
need to prepare the mesial side this is could be an option .
If the tilted molar not too much u can corrected during
preparation , if it's too much what you can do ?
Slide 6 – page 3
Now if we have tilted molar the first option is prepare molar
if we can't then we go for ortho then partial crown .
Partial crown in the lower molar should be cover mesial ,
distal , lingual , occlusal . we call it three quarter crown .
Note :
4- Cantilever FPD :
- Abutment at one end with a lever effect
When you have bridge replacing the lateral incisor if we
apply the load on the lateral incisor buccal or lingual or
palatal the whole bridge will moved . so cantilever bridge is
direct lever action or unfavorable load on the abutment , for
that reason we always use double retainer .the common ex is
mesial cantilever that replacing lateral incisor and we use a
canine as abutment . cantilever replacing first premolar and
we use second premolar as abutment this called mesial
cantilever and this preferable cantilever we don't like distal
cantilever . SO
THANK YOU