Lect. 8 ‫ عمار عطاهللا علي‬.‫د‬.

‫ا‬

Clinical Situations affecting Bridges Design (Special

problems)

C- Canine-Replacement Fixed Partial Dentures

Fixed partial dentures replacing canines can be difficult because :-

 The canine often lies outside the inter- abutment axis.
 The prospective abutments are the lateral incisor, usually the weakest
tooth in the entire arch, and the first premolar, the weakest posterior
tooth.
A fixed partial denture replacing a maxillary canine is subjected to more
stress than that replacing a mandibular canine, since forces are transmitted
outward (labially) on the maxillary arch, against the inside of the curve (its
weakest point).

On the mandibular canine the forces are directed inward (lingually), against the
outside of the curve (its strongest point). Any fixed partial denture replacing
a canine should be considered a complex fixed partial denture. No fixed
partial denture replacing a canine should replace more than one
additional tooth.
An edentulous space created by the loss of canine and any two
contiguous teeth is best restored with a removable partial denture.

D- Cantilever fixed partial dentures

A cantilever fixed partial denture is one that has an
abutment or abutments at one end only, with the other
end of pontic remaining unattached.

This is a potentially destructive design with

the lever arm created by the pontic, and it is frequently misused.

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 In the routine three-unit fixed partial denture force that is applied to the pontic is
distributed equally to the abutment teeth. If there is only one pontic and it is near the
interabutment axis line, less leverage is applied to the abutment teeth or to the retainers
than with a cantilever.
When a cantilever pontic is employed to replace a missing tooth, the pontic acts as a lever
that tends to be depressed under forces with a strong occlusal vector.
Prospective abutment teeth for cantilever fixed partial denture should be evaluated :-
 With an eye toward lengthy roots with a favorable configuration
long clinical crowns
 Good crown-root ratio
 Healthy periodontium.
Generally, cantilever fixed partial dentures should replace only one tooth and have at
least two abutments.
A cantilever can be used for replacing a maxillary lateral incisor.

Requirements:-
Cantilever pontic can be used to replace a missing lateral incisor:-
A. There should be no occlusal contact on the pontic in either centric or lateral excursions.
B. The canine must be used as an abutment and it can serve in the role of solo abutment only
if it has a long root and good bone support.
C. There should be a rest on the mesial of the pontic against a rest preparation in an inlay or
other metallic restoration on the distal of the central incisor to prevent rotation of the
pontic and abutment.
D. The mesial aspect of the pontic can be slightly “wrapped around” the distal portion of the
uninvolved central incisor to stabilize the pontic faciolingually.
The root configuration of a central incisor does not make it a desirable cantilever
abutment.

A cantilever pontic can also be used to replace a missing

first premolar. This will work best if occlusal contact is
limited to the distal fossa.
Full veneer retainers are required on both the second
premolar and first molar. These teeth must exhibit excellent
bone support. This design is attractive if the canine is unmarried and a full
veneer restoration is required for the first molar in any event.
Cantilever fixed partial dentures can also be used to replace molars when there is no distal
abutment present. When used judiciously it is possible to avoid the insertion of a unilateral
removable partial denture. Most commonly this type of fixed partial denture is used to

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 replace a first molar, although occasionally it is used to replace a second molar to prevent
supra eruption of opposing teeth.
When the pontic is loaded occlusally the adjacent abutment tends to act as a fulcrum, with
a lifting tendency on the farthest retainer.

To minimize the leverage effect

1- The pontic should be kept as small as possible, more nearly

representing a premolar than a molar.
2- There should be light occlusal contact with absolutely no contact in any
restoration of the excursion.
3- The pontic should possess maximum occlusogingival height to ensure a
rigid prosthesis.
A posterior cantilever pontic places maximum demands on the retentive capacity of the
retainer. It’s use, therefore, should be reserved for those situation in which there is
adequate clinical crown length on the abutment teeth to permit preparations of maximum
length and retention.
The success of cantilever in the periodontally compromised dentition is probably due at
least in part to the fact that periodontally involved abutments do have extremely long
clinical crowns while cantilever fixed partial dentures appear to be a conservative
restoration, the potential for damage to the abutment teeth requires that they be used
sparingly.

E- Arch Curvature

When pontics lie outside the Inter-abutment Axis Line,

the pontic act as A Lever Arm, producing Torquing
Movement.
To offset this torque, gain additional retention in the
opposite direction from the lever arm and at a distance
from the inter-abutment axis equal to the length of the
lever arm.

Effects of tooth loss:

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 If any tooth is lost, future problem will arise in the neighboring teeth, and skeletal and
muscular components of the face.
1. Drift of the neighboring teeth:
If any tooth is extracted, the adjacent teeth will drift to the extracted tooth's space. This
will lead to loss of contact between the existing teeth, and future caries.Excessive drifting
will cause the gingival proximal area to be a difficult area to be cleaned, therefore
gingival inflammation and recession might occur.

2. Over eruption of the opposing teeth:

Due to loss of a tooth, the occluding tooth in the opposing jaw will over erupt until it
occludes again, either with the other opposing teeth or the alveolar ridge. This eruption
will cause root exposure in the cervical part of the roots.
3. Occlusal malalignement:
Disturbance in the intercuspation of the teeth due to loss of a tooth will cause muscle
spasm, pain in the TMJ.

Reasons for treating tooth loss:

1- Esthetics restoration. 2- Restoring function.

2- Resolve pain in the muscles and TMJ. 4- Maintenance of dental health.
Restoring speech.
Types of bridges:

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1. Fixed-fixed bridge:
All the component of this bridge are fixed at the connector area.

2. Fixed-movable bridge:
The bridge is divided into 2 segments and they are joined in a
movable connector which is a slot or a dove tail. This type of
bridge is used when there is no alignment in the path of
insertion of the abutments.
3. Spring bridge
This bridge consist of a retainer usually a premolar, along palatal bar and a pontic
faraway from the abutment tooth, it's used when there are spaced anterior teeth.

Cantilever bridge

This bridge consist of a pontic fixed to one retainer, the pontic

size must be small in relation to abutment tooth so that the
bridge can withstand the masticatory forces.

Fixed partial dentures can be classified as either

Simple or Complex, depending on:-
1- The number of teeth to be replaced.
2- The position of the edentulous space in the arch.
The maximum number of posterior teeth that can be safely replaced with a fixed partial
denture is three, and this should be attempted only under ideal conditions.