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ABUTMENT EVALUATION

IN FIXED PARTIAL
DENTURE

COMPONENTS OF FPD

ABUTMENT
a tooth, a portion of tooth, or that
portion of a dental implant that
serves to support and/ or retain
prosthesis.

FACTORS TO BE TAKEN
INTO CONSIDERATION

CROWN LENGTH
CROWN FORM
DEGREE OF MUTILATION
ROOTH LENGTH AND FORM
CROWN- ROOT RATIO
ANTES LAW
PERIODONTAL HEALTH
MOBILITY
SPAN LENGTH
AXIAL ALIGNMENT
ARCH FORM

OCCLUSION
PULPAL HEALTH
ALVEOLAR RIDGE FORM
AGE OF THE PATIENT
PHONETICS
LONG- TERM ABUTMENT
PROGNOSIS
ESTHETICS
PYSCHOLOGICAL FACTORS

CROWN LENGTH
Adequate occlusocervical
crown- to achieve
sufficient retention.
Short clinical crown- does
not provide satisfactory
retention- full coverage
preparations are used /
crown lengthening done.

CROWN FORM
Tapered crown forms-interferes
with preparation parallelismnecessitates full coverage
retainers- to improve retention &
esthetic properties.

DEGREE OF MUTILATION
The size, number and location of
carious lesions/ restorations in a
tooth affect whether partial or full
coverage retainers indicated.

ROOTH LENGTH AND


FORM
Abutment teeth
requires anchorage
in an amount of
bone adequate to
resist occlusal
forces.

CROWN- ROOT RATIO


is defined as the physical
relationship between the
portion of the tooth within
the alveolar bone compared
with the portion not within
the alveolar bone, as
determined radiographically

ANTES LAW
It states that the combined
periodontal ligament area of the
abutment teeth should equal or
exceed that of the tooth/ teeth to
be replaced.

PERIODONTAL HEALTH
Inadequate
periodontal healthalters the
suitability of a
tooth to support
fixed prosthesis.

Periodontal disease
present should be
eliminated before
definite restorative
treatment is begun.
Proper oral hygiene
instruction should be
given to the patients.

Retainers and
pontics plannedmust promote
effective oral
hygiene.

MOBILITY
Magnitude of mobility & its cause
must be evaluated.
Miller mobility value of one- generally
acceptable.

Miller mobility
value of tworequires
assessment of
cause &
consideration of no
of replacement
teeth.

Miller mobility
value of three- not
suitable.

SPAN LENGTH
The distance between
abutment teethaffects the
feasibility of placing
a fixed prosthesis.
Replacement of one
or two teethaccomplished by
fixed prosthesis.

Replacement of
three adjacent
teeth- careful
evaluation of other
factors
Replacement of
four adjacent
teeth- only in
anterior region
where reduced
occlusal forces are
encountered.

AXIAL ALIGNMENT
Crowns of proposed
abutment must be
well aligned
retentive
preparation can be
done.

ARCH FORM
Curvature in the arches often places
pontics facial to the fulcrum line.
Counter-balancing retention must be
provided on additional teeth

OCCLUSION

Occlusal forces on the


prosthesis- related to
muscular forces, patients
habit such as bruxism, no of
teeth to be replaced,
leverage on the bridge &
bone support.
Excessive occlusal forcesloosening of the prosthesis,
fracture of the components,
tooth mobility.

PULPAL HEALTH
Abutment teeth
with poor pulpal
health- needs
endodontic
treatment prior to
tooth preparation.

ALVEOLAR RIDGE
FORM
Considerable loss
of alveolar processspace created may
be too large- to use
pontics of normal
size & length.
Removable
prosthesis is
indicated.

AGE OF THE PATIENT


Fixed prosthesis contraindicated
in the mouth of adolescentsteeth not fully erupted,
excessively large pulp chamberprohibits retentive preparation.

PHONETICS
Replacement of missing teeth with
fixed prosthesis provides sufficient
resistance to the flow of air to allow
normal speech sounds to be produced.
Existence of larger alveolar defectremovable prosthesis is needed to
produce normal phonetics.

LONG- TERM ABUTMENT


PROGNOSIS
Tooth with
questionable long
term prognosisbest maintained
with removable
prosthesis- bcoz
of bilateral bracing
afforded by rpd.

ESTHETICS
In most situations,
fixed prosthesis
provides the most
esthetic means of
replacing teeth.
Rpd is indicated- large
defect in edentulous
ridge, several teeth
missing & diastema
required.

PYSCHOLOGICAL
FACTORS
Fixed prosthesis feels more normal
than a removable one & becomes an
acceptable part of oral environment.
Fixed prosthesis is preferred over
removable prosthesis whenever
indicated.

SECONDARY
IMPRESSION

materials available
Impression Plaster
metallic oxide impression
paste
poly ether
silicone impression materials
irreversible hydrocolloid

CONSTRUCTION OF
CUSTOM TRAY
conventional auto polymerizing acrylic
resins
thermoplastic resin sheet used in vacuum
or pressure adapting devices
thermoplastic shellac base plate materials.

Diagnostic casts

Primary spacer

Secondary spacer

Wax spacer with tissue stops

Custom trays made

Requirement of custom tray


rigid and should be atleast 2mm thickness.
should retain its shape.
the method of construction should be
simple.
should be possible to trim or thin the tray
readily with a bur , mounted stone,
scissors, or an arbor band.
should be smooth.

Special tray is
prepared with handle

Borders should be
beveled.

Overextensions
are trimmed

Tray should be
short of 2 mm
from base of
sulcus

Extra clearance
in frenal areas

Border molding.
The shaping of the border areas of
an impression material by functional
or manual manipulation of the soft
tissue adjacent to the borders to
duplicate the contour and size of the
vestibule.

Refining of maxillary
impression trays

Refining of Mandibular
impression tray

Border molding in lingual


areas

Border molded
mandibular tray

PREPARING THE TRAY TO


SECURE THE FINAL
IMPRESSION

Completed maxillary final


impression

Completed mandibular final


impression

Impression technique for


hyper mobile ridges
The special tray is constructed with
relief wax placed over the mobile
ridge.
Border molding is carried out and the
final impression is made after
removing the wax spacer using a free
flowing material.