Tishk International UniversityDentistry Faculty

Prosthodontics Department

PROSTHODONTICS THEORY – DENT 281

Second Grade- Fall Semester 2020-2021

LECTURE 1: INTRODUCTION TO FIXED PARTIAL DENTURE RESTORATIONS

Instructor: Dr Vinothkumar Sengottaiyan M.D.S.

Possible deleterious effects of missing/ lost teeth

▪Loss of efficient function (mastication , speech etc.) and esthetics

▪Alteration of occlusal plane and loss of space available for restoration–due to migration of existing teeth into missing space

▪Overloaded occlusion – causing traumatic mobility and attrition of remaining teeth

▪Loss of contacts between teeth – due to migration – resulting in food impaction between teeth –leading to caries/ periodontal inflammation and loss of many more natural teeth

▪Eventual loss of all remaining teeth resulting from the aboveeffects, leading to dental, oral, and facial disability and disfigurement

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SEQUALE OF MISSING MOLAR – POSSIBLE LOSS OF MULTIPLE TEETH

Fixed partial denture

•Fixed partial denture \fĭkst pär΄shal dĕn΄chur\: any dental prosthesis that is luted, screwed, or mechanically attached or otherwise securely retained to natural teeth, tooth roots, and/or dental implants/abutments that furnish the primary support for the dental prosthesis and restoring teeth in a partially edentulous arch; it cannot be removed by the patient

Indications for fixed partial dentures

• Patient’s desire to have a fixed prosthesis

• Short edentulous spaces with healthy abutment teeth

• Patients with good oral hygiene and low caries incidences

• Patients who cannot maintain removable dentures

• As an alternative to dental implants (which require surgical procedures- some patients are scared of surgical procedures)

• Patients who have seizures, posing risk of aspiration of the removable dentures

Contraindications - fixed partial dentures

• Young patients with large pulp

• Long or multiple edentulous spans crossing

• Small and weak abutments

• Patients who refuse to get their natural tooth altered by grinding/preparation to receive a retainer/crown

• Patients with poor oral hygiene and high caries activity

• Patients with active temporomandibular joint problems and occlusal problems – these patients require full mouth rehabilitation

Parts of fixed partial denture

Types of fixed partial dentures (based on support)• Conventional tooth supported FPD

• Resin bonded FPD

• Implant supported FPD

Types of FPDs (Based on rigidity)• Fixed – fixed bridge

• Cantilever bridge

• Fixed – movable bridge

•Fixed – removable bridge (Andrew’s bridge)

Specific Indications-fixed/fixed bridge• Short edentulous spans

• Edentulous ridges with minimal bone loss

• When abutments are periodontally compromised -requirement for splinting to prevent further mobility

• When there is a heavy occlusion from opposing arch – requirement for load distribution

Specific indications-cantilever bridge• For replacing teeth that encounter minimal occlusal forces

(maxillary lateral, mandibular premolar)

• When patient disagrees with preparation of two natural teeth

• When the distal abutment teeth is stronger with no caries and periodontal involvement

• When the missing teeth/implant is mesial to the proposed abutment

• As a temporary restoration over an implant submerged for healing

Specific Indications-fixed movable bridge• For cases where there is a pier abutment

• For cases that have tilted abutments

• For cases with diastema which require space between retainers and pontic

SPECIFIC INDICATIONS-FIXED removable BRIDGE

• Also called as Andrew's bridge

• Used in Siebert's class 3 defect of edentulous ridges

• Especially in anterior areas where there is requirement to replace lost alveolar bone component

• The situation is more common for patients losing the teeth due to trauma and avulsion along with cortical bone plate

• This restoration gives better lip support, at the same time remains stable and rigid

Types of FPD based on materials▪ Metal ceramic

▪ Precious/noble metal alloy based (gold, palladium, platinum, silver etc) + feldspathic porcelain

▪ Base metal alloy based (Nickel-Chromium, Cobalt-Chromium) + feldspathic porcelain

▪ All metal

▪ Gold, Stainless steel, Nickel-Chromium

▪ All ceramic

▪ Feldspathic porcelain – mainly used for single crowns and veneers

▪ Glass ceramics – Lithium disilicate- can be used for small bridges, single crowns and veneers

▪ Metal oxide ceramics – Zirconia, Alumina – high strength, can be used in places requiring high strength, for replacing molar teeth.

Base metal

▪ Acrylics & Resins

▪ PMMA - Traditional self-cured or heat cured, and cad cam milled – used for short to long term temporary

▪ BisGMA based Acrylic for direct intra oral temporary crown and bridge fabrications

▪ Urethane dimethacrylate - Light curable resin for direct temporary crown and bridge

▪ Polycarbonate shells

▪ for single tooth temporary- may be lined with acrylic

▪ PEEK

▪ Bio compatible polymeric material- could be used to make framework for composite layering

Thank you!!