What information is required about the occlusion when planning for bridgework?
- face bow mounted study casts
- incisal classification
- canine guidance vs group function
- opposing teeth over erupted?
- any signs of parafunction
What should be evaluated in potential abutments?
- angulation/rotation of abutment
- root configuration
- surface area for bonding (adhesive)
- risk of pulpal damage (conventional)
- quality of endodontics
What are the different types of pontic?
- wash through
- dome
- modified ridge lap
- ridge lap
- ovate
What is the function of a pontic?
- restore appearance
- stabilise occlusion
- improve masticatory function
What are the considerations when choosing a pontic design?
- cleansability
- appearance
- strength
Describe the ideal cleansability of a pontic.
- surface smooth (highly polished or glazed)
- surface should not have join of metal or porcelain as occlusal load can damage (also plaque trap)
- embrasure should be smooth and cleanable
Describe the ideal appearance of a pontic.
- in the anterior pontic should look as tooth like as possible
- in the posterior this is sometimes compromised for function
Describe the strength required of a pontic.
The longer the span of the pontic the thicker the material required to withstand occlusal forces
Describe a wash through pontic.
- makes no contact with soft tissue
- functional rather than for appearance
- lower molar area
Describe a dome pontic.
- acceptable when occlusal 2/3 of buccal surface is visible
- coronal 2/3 normal, narrowing to a point at soft tissues
- lower incisors, lower premolar, upper molar areas
Describe a modified ridge lap pontic.
- buccal surface looks like tooth
- lingual surface cut away
- small contact with soft tissues at ridge
- can have problems with food packing
Describe a ridge lap pontic.
- has greater contact with soft tissues
- still cleanable if designed correctly
- less food packing than modified ridge lap
- patient requires good OH
Describe an ovate pontic.
- good for patients with excellent OH who require good aesthetic result
- presses into gingiva causing moulding around tooth going the appearance of a gingival margin
- requires Essix retainer with ovate pontic to pre-mould prior to definitive bridge
What are the different types of materials used for conventional bridges?
- all metal
- metal ceramic
- all ceramic
- ceromeric (historical)
What material is used in all ceramic bridges?
- zirconia (LAVA)
- lithium disilicate (E-max)
What material are used in ceromeric bridges?
BelleGlass
What is a ceromeric material?
Composite and ceramic hybrid (historical)
What are the different types of implant retained bridges?
- screw retained
- cement retained
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1 - Bridgework40
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2 - Bridgework 219
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3 - Bridgework 319
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4 - Wear40
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5 - Wear 224
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6 - Wear 315
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7 - Shortened dental arch22
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8 - Tooth wear 125
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9 - Tooth wear 27
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10 - Tooth wear 319
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11 - Implant planning and placement39
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12 - Implant restoration19
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13 - Endodontic interface22
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PCS - Wear 16
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PCS - Wear 24
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PCS - Wear 32
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PCS - Fibre post3
