Effect of Tooth Loss & Types of Bridges

First Term: 2010-2011

M. Abdel Mohsen El-Soud B.D.S, D.D.S, D.D.Sc. Prof. Department of O.M.R Fixed Prosthodontics

Causes of Tooth loss:

1) Dental caries & failure of root canal treatment.

2) Periodontal diseases

3) Accidental trauma.

4) Failure of eruption

 Partial of space due to early loss of tooth

(neoplastic disease). Loss of space due to early loss of tooth Impaction Pathology(dentigerous cyst)

5) Ageing

Sequence of tooth loss

Super-eruption of opposing

Tilting of adjacent Loss of proximal contact

Apical migratinof contact

Stability of the tooth depends on:

Balance of the forces exerted on the tooth

by
Adjacent tooth Supporting tissues Opposing tooth

Soft tissues

Super eruption of opposing

Trauma to edentulous area

Open contact
Food impaction Caries Pocket formation

Premature contact
Weare facets Traumatic occlusion TMJ problems

Tooth loss

Anterior

Posterior

#Esthetic
#Phonetic #Function

#Mastication #Stability

Effect of tooth loss:

Trauma from occlusion
Pocket formation

Bone loss

 Caries

TMJ problems
Loss of V.D

 Pneumatization of maxilary sinus

Psychologic disturbance

 Facial atrophy
Muscular spasms

Methods of replacing missing teeth

1. Implants or implant supported FPD 2. FPD 3. RPD

Types of bridges

Types of Bridges
According to Design: 1.Fixed fixed. 2.Fixed movable. 3.Cantilever bridge. 4.Spring cantilever bridge. 5.Compound (complex) bridge. 6.Resin bonded bridges. 7.Implant supported bridge.

Fixed-Fixed
The artificial tooth supported ridgly by both side by one or more abutment teeth or implant by ridge connector.

Fixed-Movable

Cantilever

Spring Cantilever

Spring cantilever bridge

Prosthesis where artificial tooth is supported by connecting bar to abutment tooth or teeth.

Compound bridge
It is a combination of more than one type of bridge is used.

Fixed-fixed with spring Fixed-fixed with cantilever Fixed-fixed with fixed movable

Indication:
Different path of insertion.

Different distribution of abutment.

Resin bonded bridge

Prosthesis constructed of a cast metal framework which is luted to the enamel of an abutment teeth by an adhesive resin.

Implant Supported

According to Materials: 1. Metal 2. Non metal 3. Combination

According to location: 1. Anterior 2. Posterior 3. Upper 4. Lower

Components of a bridge
Pontic

Connector

Retainer

Abutment

Think of each patient individually

Patient attitude General Health Age Occupation cost

When designing a bridge..

Proper examination. Abutment selection. Retainer selection. Pontic Selection. Connectors selection.

What should we think of before fabricating a bridge?

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Span length Span position Abutment condition Abutment Position Occlusion and TMJ Root and supporting tissues Ridge form Edentulous span distribution Arch curvature Double abutments

Abutment Selection

Retainer Selection
Complete Coverage Full metal PFM All ceramic Proximal half crown Inlay retainer MOD onlay Partial Coverage crown Reverse 3/4 crown 7/8 crown

Full Metal

PFM

All Ceramic

 Crown

Reverse Crown

7/8 Crown

Proximal 1/2

Inlay retainer

MOD onlay

Pontic Design

According to Material

According to support

According to Design

According to Design

Connectors design

Rigid Casted Solder Porcelain

Non rigid Dovetail Split pontic Cross-pin & wing

Connector Selection depends on

1. 2. 3. 4.

Location of the embrasure Type of retainer Spacing between teeth Position & number of abutment

Simple FPD
two teeth

Complex FPD
more than 2 teeth

Pier Abutment

Thank You