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Fpdintroduction 100203103114 Phpapp02
Fpdintroduction 100203103114 Phpapp02
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
COMPLETE
PARTIAL
: Extracoronal. : Intracoronal
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.
social
function appearance
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
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
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
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
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
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
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
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
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.
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
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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