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GOOD MORNING

PROSTHODONTICS
definition
Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues using biocompatible substitutes

BRANCHES

FIXED

REMOVABLE

MAXILLOFACIAL

: Fixed : Movable : Removable

COMPLETE

PARTIAL

: Extracoronal. : Intracoronal

INTRODUCTION TO FIXED PARTIAL DENTURE

JINISHNATH (Final Year ,Part I )

FIXED PARTIAL DENTURE Definition


A partial denture that is luted or otherwise securely retained to natural teeth, tooth roots and/or dental implant abutments that furnish the primary support to the prosthesis- GPT

FIXED PROSTHODONTICS.
Fixed prosthodontics pertains to the restoration or

replacement of teeth with artificial substitutes that are attached to natural teeth, roots or implants and that are not readily removable.

FOR SUCESSFUL TREATMENT


Meticulous attention to every details
patient interview diagnosis and education prevention of dental disease periodont. Therapy (if indicated) occl. Consideration Appropriate treatment plan operative skills and treatment follow up care

Usually belongs following categories following categories


comfort

social
function appearance

Personal details Medical history


Medical condition affecting treatment method, treatment plan and systemic condition

Dental history
Periodontal history Restorative history Endodontic history

Surgical history
Tmj dysfunction history

Examination
General examination Extra oral examination Tmj Muscles Lips

Intraoral examination
Periodontal
Occusal

Radiographic examination

INDICATIONS OF FIXED PROSTHESIS.

One or two adjacent teeth are missing in the same arch or

short span edentulous arches. 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. Patients preference

Contraindications for a Fixed Prosthesis


o Necessary supportive tissues are diseased or missing.
o Suitable abutment teeth are not present. o The patient is in poor health.

o The patient is not motivated to have the prosthesis

placed. o The patient has poor oral hygiene habits. o The patient cannot afford the treatment.

Common Terms
CROWN Laminate Veneers/Facial Veneers

INLAY ONLAY

ABUTMENT PONTIC
CONNECTORS RETAINER

CROWN
It is a cemented extracoronal restoration that covers or

veneers the outer surface of the clinical crown. Primary function is to protect the underlying tooth structure & restore the function, form and esthetics. TYPES
1) Full veneer crown. 2) Partial veneer crown. :-three quarter crowns :-reverse three-quarter crowns :-seven-eight crowns :-pinledges :-inlay :-onlay

Full Veneer Crown (cast metal)

If it covers all of the crown, the restoration is a full or

complete veneer crown It may be fabricated entirely of a gold alloy or some other untarnishable metal, a ceramic veneer fused to metal.

INDICATIONS Teeth that have extensive coronal destructions by caries or trauma Restoration of choice whenever maximum retention is needed Indicated on endodontically treated teeth Correction of occlusal plane CONTRAINDICATIONS If less than maximum retention and resistance is needed Wherever intact buccal or lingual wall exists Enameloplasty For high esthetic needed exists like anterior teeth

Advantages
Strong High retentive qualities Can be modify form and occlusion Easy to obtain adequate resistance form

Disadvantages
Removal of large amount of tooth structure

Display of metal

METAL CERAMIC CROWNS

The restorations consists of a complete coverage cast metal crown that is veneered with a fused porcelain to mimic the appearance of a natural tooth

Indications
Esthetics Gingival involvement If porcelian jacket crowns is contraindicated

Contraindications Large pulp chamber Intact buccal wall

Advantages
Superior esthetics Retentive qualities are excellent

Disadvantages
Removal of substantial tooth structure Fracture can occur Difficult to obtain accurate occlusion in glazed porcelain expensive

Partial Veneer Crown


An extracoronal metal restorations that covers only part of the clinical crown is considered to be a partial veneer crown
Partial Veneer Crown MOD Gold Onlay

Indications
Clinical crown of average length or longer Intact buccal/labial surface Well supported by sound tooth structure

Contraindications
Short teeth High caries index Extensive destruction Not used in endodontically treated teeth Poor alignment Bulbous teeth Thin teeth

Advantages
Conservative of tooth structure Easy access to margins Less gingival involvement Verification of seating simple

Disadvantages
Less retentive than full crown Limited adjustment of path of withdrawal Not indicated on vital teeth

Three-quarter crowns

This type of crowns restore the occlusal surfaces and the three of the four axial surfaces but not including the facial surfaces

Pinledge
Indications

A partial veneer retainer preparation incorporating pins holes to provide retention

High esthetic requirement Undamaged anterior teeth When proximal grooves are impossible to prepare To alter lingual contour of maxillary anterior teeth

Contraindications
Large pulp Non vital teeth Thin teeth carious involvement

Advantages
Minimal tooth reduction Minimal marginal length Minimal gingival involvement Adequate retention Excellent esthetics

Disadvantages
Less retentive Techanically demanding

INLAY
A fixed intracoronal restoration; a dental restoration made outside of a tooth to correspond to the form of the prepared cavity, which is then luted into the tooth
Inlay may be used as a single tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions. They may be made up of gold alloy or ceramic material. Inlays are similar to fillings but the entire work lies within the cusps on the chewing surface of the tooth.

Indications
Small carious lesion Adequate dentinal support Low caries rate Patient request for gold restorations

Contraindications
high caries index
Poor plaque control MODs Poor dentinal support require wide preparation

ONLAY
A restoration that restores one or more cusps and adjoining occlusal surfaces or the entire occlusal surface and is retained by mechanical or adhesive mean
It is used for restoring more extensively damaged posterior teeth needing wide mesio-occluso-distal restorations.

Indications
Worn or carious teeth with intact buccal and lingual cusps MOD amalgam requiring replacements
Low caries rate

Contraindications
High caries risk poor plaque control Short clinical crown/extruded tooth bruxism

Laminate Veneers/Facial Veneers


It consists of a thin layer of dental

porcelain or cast ceramic that is bonded to the facial surfaces of the tooth with an appropriate resin It is used in situations requiring an improved cosmetic appearance on the anterior tooth.

PARTS OF FIXED PARTIAL DENTURE RETAINER ABUTMENT PONTIC CONNECTOR

RETAINER
Any type of device used for the stabilization or retention of a prosthesis
Positioned at margin - less susceptible to caries or recurrence of caries Rigidity withstand the requisite load Functional adaptation and protect the tooth against its fracture Least destroys the cervical marginal ridge

Types of retainer
Full veneer crowns Partial veneer crowns Conservative retainers All metal retainers Metal ceramic retainers All ceramic retainers All acrylic retainers

Pontics
An artificial tooth on a fixed dental prosthesis that replaces a missing natural tooth, restores its function, and usually fills the space previously occupied by the clinical crown

Pontics

Requirements of pontics
-restore function -provide esthetics and comfort -be biologically acceptable -permit effective oral hygeine -preserve underlying residual mucosa
Material used Metal-ceramic pontics Resin veneered All metal Facings

ABUTMENT
A tooth, a portion of a tooth, or that portion of a dental implant that serves to support and/or retain a prosthesis

Connectors
Fixed dental prosthodontics, the portion of a fixed dental prosthesis that unites the retainer(s) and pontics Types-Rigid connectors -Non rigid connectors -tenon mortise connectors -loop connectors -split pontic connectors -cross pin and wing connectors

Nonrigid connectors

Loop connectors
Loop connectors are used for when existing diastema is to be maintained in the planned fixed prosthesis
T he connector consists of a loop on the lingual aspect of the prosthesis that connects adjacent retainers and /or pontics

FUNCTIONS OF FIXED PARTIAL DENTURE


Provide proper occlusal function.
Maintain arch integrity/tooth position. Maintain occlusal relationships. Protect and preserve the remaining structures.

REFERENCE
Fundamentals of Fixed Prosthodontics Third edition. Herbert.T.Shillingburg. Theory and practice of Fixed Prosthodontics. Tylmans Contemporary Fixed Prosthodontics.stephen F Rosenstiel

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