Lecture about Crown and bridge clinically in dental.pdf

Dentistry

1. Crown and Bridge
prosthodontics
Lecture 1
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2. Prosthodontics (prosthetic dentistry or prosthodontia)
The dental specialty concerned with restoration
and maintenance of oral function, comfort,
appearance and health of the patient by making
artificial replacements for missing parts of the
mouth and jaw.
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3. Branches of Prosthodontics
•Fixed Prosthodontics
•Removable Prosthodontics
Complete Denture
Removable Partial Denture
•Implant Prosthodontics
•Maxillofacial Prosthodontics
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4. Fixed prosthodontics
(Crown and Bridge prosthodontics):
•It’sabranchofdentalsciencethatdealswith
restorationofdamagedteethwithartificial
crownandreplacingthemissingnaturalteethby
adentalprosthesispermanentlycementedin
place[Fixedpartialdenture].
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5. Types of Fixed Prostheses:-
•Extracoronal;involvealltherestorationthatseat
overthetoothsuchasalltypeofcrownrestorations
(fullmetalcrown,partialcrown,PFM,allceramic
crown…..)anddirectorindirectveneerrestoration
•Intracoronal;involvealltherestorationthatseat
insidethetoothsuchasinlay,onlays,pinlage.
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7. Fixed Prosthodontics involve :
•Inlays-gold and all ceramic
•Gold crowns-full and partial veneer
•Porcelain & Zirconium-all porcelain and PFM
•Fixed partial dentures
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8. Crown:-
•It'sfixedextracoronalartificialrestorationofthe
coronalPortionofanaturaltooth.
•Itmustrestorethemorphology,functionandthe
contourofthedamageportionofthetoothand
shouldprotecttheremainingtoothStructuresfrom
fartherdamage.
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9. Types of crowns: (classification)
A-According to coverage area
B-According to Materials
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10. Types of crowns:(classification)
A-According to coverage area
1-Complete crown: It is the crown that coversall
the coronal portion of the tooth, such as full metal
crown,All Ceramic crown which is a complete crown
madeof ceramic material.
2-Partial Crown: It is a crown That covers part of
the coronal portion of the toothsuch as 3/4 Crown,
7/8 Crown.
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11. Types of crowns:(classification)
A-According to coverage area
3-Complete replacement: it involves those which
replace the natural crown entirely. This type of
crown retains itself by means of a metal extended
inside the root canal space of the tooth such as a
post crown.
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12. B-According to Materials:
According to Materials used in the construction of
crown and Bridge crown restorations could be made of:
1-Metal Crowns {Gold alloy And it's alternatives} as
in Full metal Crown and 3/4 Crown.
2-Non metal crowns: Such as { Acrylic resin ,
Zirconiumor Porcelain}as in jacket crown.
3-A combination: of metal and plastic materials as in
PFMand PFZCrown restorations.
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13. Fixed Partial Denture (Bridge)
Itisafixeddentalprosthesis(appliance)which
replacesandrestoresthefunctionandestheticof
oneormoremissingnaturalteeth;itcannotbe
removedfromthemouthbythepatient.Itis
primarilysupportedbynaturalteethorroot.
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14. Components of the bridge:
1.Retainer:It'sthepartthatseatover(onorin)the
2.AbutmenttoothWhichcouldbemajororminor,
connectingthepontictotheabutment,itiseither
majororminorretainer,&itcouldbecrown,inlay,post
&core.
3.Pontic:Itisthesuspendedmemberoffixedpartial
denturethatreplacesthemissingtoothorteeth,
usuallyitOccupiesthepositionOfthemissingnatural
tooth.
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15. 4.Connector:ItPartofF.P.Dthatjointheindividual
componentsofthebridgetogether(retainer&pontics),
whichcouldbefixed(rigid)ormovable(flexible)
connector.Whentheretainerisattachedtoafixed
connectorit'scalledamajorretainer,butwhenitis
attachedtoaflexible[movable]Connectoritiscalled
aminorretainer.
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17. Definitions (terminology)
1.Abutment:a tooth to which a bridge attached.
2.Span:is the space between natural teeth that
is to be filled by pontics.
3.Saddle:is an area of the edentulous ridge over which
the ponticlies.
4.Pier:is an abutment standing between two
abutments & supporting two pontics, each ponticbeing
attached to further abutment.
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18. 5.Unit: when applied to bridgework, means
either a retainer or a pontic;(thus bridge replace
premolar & use twoabutmentsmay referred as
three-units bridge).
6.Path of insertion; An imaginary line along which
the restoration can be inserted and removed without
any interferences or causing lateral force on the
abutment.
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20. Why doing a Fixed Partial Denture?
The stability of an individual tooth depends on a balanceof the
forces excrete on that tooth by the adjacent, opposing teeth,
supporting tissue & by the soft tissue of the cheek, lips, &
tongue.
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21. After Loss
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22. When a single tooth is not replaced (after loss),
this balance is upset, & the consequence mayby:
1-Tilting (drifting) of the adjacentteeth
2-loss of the proximal contactto:-
Food stagnation &pocketing
periodontal problem &mobility
Sub-gingivalcaries
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23. 3-Super eruption of the opposing tooth orteeth
Gingivalrecession
Traumatic occlusion or lacking ofbite
Loss of bony support for thattooth.
loss of the proximal contact
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24. 4-Loss of function on the affectedside:
Diffuseatrophy.
Heavy deposition of plaque & this lead to
gingivitis & periodontaldisease.
Trauma to the soft tissue duringfunction.
Loss of tissue (contraction of both soft tissue &
alveolarbone)
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25. 5-posterior bitecollapse
The posterior teeth also support the vertical
height of the face. If they are lost, the face tends to
lose height and close down; this is called “posterior
bite collapse”
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27. The general effect of tooth loss:
1-Generalized collapse of lower & upper dentalarch
2-Premature contact causing deviation in the normal
movement of the mandible, this may result in T M J
dysfunction & muscle spasm thatcause pain
3-Tooth loss may lead to unilateral mastication on the
opposite side of thedentalarch which results in
periodontal problems, caries on the affected side due to
deficient mechanical cleaning afforded by the act of
mastication.27

28. 4-posterior bite collapses these changes also put pressure
on the front teeth which tend to move or splayforward
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29. Treatmentatthisstagepreventsfurtherdisruption,it
maybeinsufficienttorationbacktofullhealth,itneeds
extendedtreatmentplansincluding,ortho.Treatment,
additionalcastrestorationtocorrectdisturbedocclusal
plane.
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30. IN SOME CASES THE DECISION MIGHT BE
NO PROSTHETIC TREATMENT ????!!!!!!!!!!!!!!
-Long standing edentulous space into which there has been
little or no drifting or elongation of the adjacentteeth.
-If the patients perceive no functional, occlusal or esthetic
impairment.
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31. * Reasons for treating tooth loss
1-Esthetic
2-Function (ability toeat)
3-Pain due to TMJ dysfunction & musclespasm
4-Maintenance of dental arch (occlusal stabilization
& preventtilting)
5-Speech (particularly lowerincisors)
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32. Methods of treating tooth loss
Orthodontic.
Removable partialdenture.
Fixed partial denture (tooth supported partialdenture).
Implant ( osseo-integratedimplant).
Combination.
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