Prostho Rehab of CP with andrews bridge final.pptx

prosthodontic rehab with andrews bridge

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2. Lt.Col Muhammad Sajjad HoD Prosthodontics Dr.Kainat Saleem FCPS Resident Prosthodontics Prosthodontic Rehabilitation of a Cleft Palate Patient with Andrews Bridge: A Case Report Rachana Chaudhary , PG Resident, Department of Prosthodontics and Crown and Bridge, Army Dental Centre, Research and Referral, Delhi Cantt-110010, Delhi, India,

3. 3 CRITICAL APPRAISAL TITLE Prosthodontic Rehabilitation of a Cleft Palate Patient with Andrews Bridge: A Case Report AUTHORS Rachana Chaudhary * , Dinesh Kumar, Amit Khattak , R K Yadav , Anup Gopi and Dhruv Sharma JOURNAL International Journal of Oral and Dental Health Chaudhary et al. Int J Oral Dent Health 2020, 6:107 METHODOLOGY Case Report

4. OUTLINE

5. CASE REPORT

6. Name : XYZ Age : 25 years Gender : Male Chief complaint : Missing upper front teeth Medical history : Operated for cleft lip and palate 6 HISTORY

7. M issing teeth 22 , 23,24 & 25 with a nterior ridge defect . INTRAORAL EXAMINATION

8. Partially Dentate Maxillary arch with Kennedy’s class III S eibert's class-III ridge defect on left maxillary anterior region DIAGNOSIS

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10. After discussing all possible treatment options with the patient a treatment plan was formulated and it was decided to rehabilitate the patient with fixed-removable Andrews bridge prosthesis. . TREATMENT PLAN

11. 1st Visit Complete oral prophylaxis was carried out Diagnostic impressions were made with irreversible hydrocolloid TREATMENT STEPS

12. Lab Steps: Impressions were disinfected Diagnostic cast was prepared by using type 3 dental stone Interim acrylic partial denture was fabricated

13. 2 nd Visit: Tooth preparation was done on 11, 12 and 26 to receive PFM crowns that will be connected with bar attachment

14. Final impression was recorded with two stage putty wash technique using polyvinyl siloxane impression material

15. Temporization with tooth colored acrylic I nterim RPD was inserted

16. Lab Steps: Fabrication of master cast with type 4 dental stone Wax up was done on 11, 12 and 26 for PFM crown & connected with prefabricated plastic bars Bar placed parallel to the ridge Casting was done Finishing and polishing Metal framework trial on the master cast

17. 3 rd Visit: Intraoral trial of Metal framework Shade selected

18. Lab Steps: Ceramic layering was done according to the selected shade

19. 4 th Visit: FDP cementation with luting GIC. Blocking out the under surface of the bar Impression recorded with alginate to fabricate removable component of the prosthesis

20. Lab Steps: Fabrication of master cast with type 4 dental stone Removable component of Andrews bridge was made

21. 5 th Visit: Under surface of the bar was blocked and clips were attached to the bar Picked up with autopolymerising PMMA into the removable p rosthesis

22. Final insertion and adjustment of removable prosthesis was done Post insertion instructions were given Recalled for regular follow up

23. DISCUSSION

24. A fixed-removable prosthesis that was first introduced by Dr . James Andrews It permits the replacement of the lost teeth and supportive structures . It offers both function and aesthetics 24 Andrews Bridge

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26. The support mechanism is shared by the teeth, and the tissues to some extent The bar serves as a retentive and stabilizing tool for the removable segment The acrylic prosthesis can be removed by the patient when desired for hygienic access 26

27. Large ridge defect (due to congenital reasons, trauma or surgery) Short Edentulous span When the fabrication of a conventional fixed dental prosthesis is excluded because of the large ridge defect. Where abutments are capable of supporting a fixed partial denture Cleft palate patients (with congenital or acquired defects) INDICATIONS OF ANDREWS BRIDGE

28. Better aesthetics Better adaptability Better phonetics Hygienic Comfortable Economical No palatal extension required The taste perception is unaltered ADVANTAGES

29. W earing away of the plastic clip A dditional lab steps N eeds meticulous planning during the placement of the bar to prevent tissue impingement If used for long spans , there will be increased flexure of the metal bar and will lead to failure of the prosthesis DISADVANTAGES

30. The post surgical rehabilitation of ridge defects in aesthetic zone is always a challenging situation for dental practioners . Andrews bridge is a good treatment option to rehabilitate patients with ridge defects providing optimum asthetics and function with enhanced patient adaptability and comfort. CONCLUSION

31. William L McCracken (1965) Partial denture construction. (2 nd   edn ), The CV Mosby Company, St. Louis. Van den Bergh JP, Ten Bruggenkate CM, Tuinzing DB (1998) Preimplant surgery of bony tissues. J Pros Dent 80: 175-183. Robert J Everhart, Edmund Cavazos Jr (1983) Evaluation of a fixed removable partial denture: Andrews bridge system. J Pros Dent 50: 180-184. Hickey AJ, Salter M (2006) Prosthodontic and psychological factors in treating patients with congenital and craniofacial defects. J Prosthet Dent 95: 392-396. Ozlem A, Burcak K, Muhammet S, Bulem Y (2013) Prosthodontic rehabilitation of cleft lip and palate patients with conventional methods: A case series. Int J Prosthodont Restor Dent 3: 120-124. Rathee M, Sikka N, Jindal S, Kaushik A (2015) Prosthetic rehabilitation of severe Siebert's Class III defect with modified Andrews bridge system. Contemp Clin Dent 6: 114-116. Prasan KK, Joshi S, Shalini BN, Sowjanya K, Jessudass G (2014) Achieving esthetics with Andrews bridge. Int J Prosthodont Restor Dent 4: 127-130. Muthuvignesh J, Bhuminathan S, Egammai S, Narayana RD (2013) Improving facial esthetics with Andrews' bridge: A clinical report. Int J Multidiscip Dent 4: 884-887. DeBoer J (1993) Edentulous implants: Overdenture versus fixed. J Prosthet Dent 69: 386-390. Finley JM (1998) Restoring the edentulous maxilla using an implant-supported, matrix-assisted secondary casting. J Prosthodont 7: 35-39. Cura C, Saraçoglu A, Cötert HS (2002) Alternative method for connecting a removable gingival extension and fixed partial denture: A clinical report. J Prosthet Dent 88: 1-3. Immeleus JE, Aramany M (1975) A fixed-removable partial denture for cleft palate patients. J Prosthet Dent 34: 286-291. Cheatham JL, Newland JR, Radentz WH, O'Brien R (1984) The 'fixed' removable partial denture: Report of case. J Am Dent Assoc 109: 57-59. REFERENCES

32. 32 Thank You