What occlusal information do we need when prescribing a bridge?
- facebow transfer
- incisal classification
- canine guided or group function?
- are opposing teeth over erupted?
- signs of parafunction present?
- will bridge interfere with current occlusion
What must be examined in order to evaluate potential bridge abutment teeth?
- root configuration
- angulation of tooth
- perio health
- surface are for bonding & enamel quality
- risk of pulpal damage
- quality of endo
- remaining tooth structure present?
What considerations need to be made about pontic design in bridges?
- cleansability = should always be smooth
- appearance
- strength
What change must be made to pontics in a wider spanned bridge design?
Thickness of pontic must be increased to withstand occlusal forces
How can pontics be designed to ensure they are easily cleaned?
- smooth surface (highly polished/glazed)
- surface should not harbours join of metal & porcelain
- embrasure space should be smooth
What materials can be used for conventional bridges?
- gold, nickel/CoCr, stainless steel
- zirconia
- lithium disilicate
- ceromeric
What different types of bridge pontic can you prescribe & ask the lab for?
- wash through pontic
- dome pontic
- modified ridge-lap pontic
- ridge lap pontic
- ovate pontic
Where are wash through pontics typically used in the mouth?
- lower molar area
What are wash-through pontics?
Pontics that make no contact with soft tissue - essentially float above soft tissue
- functional rather than for appearance
What are dome-shaped pontics?
Bullet-shaped or torpedo-shaped pontics
- useful in lower incisor, premolar or upper molar areas
When are dome-shaped pontics best used?
When occlusal 2/3rds of buccal surface is visible only (poor aesthetics if gingival 1/3 of tooth visible)
What problems are associated with modified ridge lap pontics?
food packing issues on lingual surface of ridge (as lingual surface is cut away)
What are ridge surface pontics?
Pontics with greatest contact with soft tissue
- less food packing that ridge-lap
- bleaching of tissue can occur
What is the best restorative metal to use for bridges?
Gold !!
Where in the mouth is gold (as part of bridgework) especially useful for?
Lower posterior area
If you are undertaking conventional bridgework, but the abutment teeth have a short clinical crown height, what can you do to make the bridge more retentive?
Prep retentive features such as:
- slots
- grooves
For metal conventional bridgework, what cement can be used?
- aquecem (GI luting cement)
- relyX luting (RMGI luting cement)
For adhesive/resin-retained bridgework, what cement can be used?
Panavia 21
Why should you aim to avoid distal cantilever bridges?
Occlusal forces on pontic will produce leverage forces on abutment tooth causing tilting
