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DIAGNOSA

GIGI TIRUAN JEMBATAN

DEWI KRISTIANA

What are the functions of a fixed


partial denture?
What Structures
Provide Proper Occlusal
Function
Maintain Arch Integrity/Tooth
Position
Maintain Occlusal Relationships
Protect & Preserve the
Remaining Structures

Before a Diagnosis (Dx) is made,


thorough data collection is
necessary.
Radiographs
Articulated Diagnostic Casts
Medical, Social, and Dental

Histories
Clinical Examination
Periodontal Charting
Endodontic Vitality Tests
Patient Expectations of

Order of Treatment Plans


1) Disease Control Phase
- patients are freed of pain & rampant disease
1) Endodontics
2) Oral Surgery
3) Caries Control
2) Periodontal Phase
1) Scaling/Root Planing & Surgical Methods
2) Improved Patient Homecare
3) Re-Evaluation

3) Restorative Phase
1) Operative Dentistry
2) Fixed Prosthetics
3) Removable Prosthetics

4) Maintenance & Prophylaxis Phase


1) Periodontal
2) Restorative
3) Radiographic

FPD Treatment Planning


1. Abutment Evaluation
Tooth Vitality
Periodontal Status
Crown-to-Root Ratio
Root Configuration
Periodontal Surface Area (Antes Law)
Clinical Crown Length
Relation of Long Axis to Path of Insertion
2. Biomechanical Considerations

Tooth Vitality
Ideally, wed like for an abutment to be

free of any endodontic complications.


However, the use of endodontically
treated teeth is not contraindicated as
long as it has enough structure or buildup material to adequate serve as an
abutment.
Teeth with questionable vitality require a
choice of doing elective endodontics
prior to treatment or seeing what time
has to offer

Periodontal Status
Inflamed gingiva bleed

make
preparation and impression making
more difficult.
Mobile teeth may not be able to
support any span under occlusal
stress for very long.
We prefer to do any restorative
work on stable teeth and around
healthy gingiva.

Crown-to-Root Ratio
Ideally, a clinical crown-to-root

ratio of 2:3 is sought after.


Minimally, wed like to see a 1:1 for
a tooth to be considered for use as
an abutment.

Root Configuration
The shape of the roots also determines the

ability of the root to handle occlusal forces.

Teeth with a wider


bucco-lingual
dimension than mesiodistal have a greater
ability to handle load
than conically shaped

Multi-rooted teeth with


separated roots are
better at displacing
occlusal load than teeth
with conjoined roots.

Periodontal Surface Area (Antes Law)

Ideally, the periodontal surface area of

the abutment teeth should be greater


than or equal to the periodontal surface
area of the missing teeth.
In cases where the periodontal surface
area seems inadequate, the use of
multiple teeth for abutments may be
indicated depending on other
biomechanical factors.

Clinical Crown Length


Abutment teeth (and preparations) should have

adequate outermost mesial and distal wall heights


in order to counteract the dislodging mesial-distal
forces that a bridge will encounter.

Teeth with short clinical crowns may not be

ideal abutments.

TERIMA KASIH

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