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FIXED PROSTHODONTICS - Lectures

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					FIXED PROSTHODONTICS - Lectures
Introduction to dental prosthetics.
Prosthodontics may be defined as that branch of dentistry pertaining to the restoration and
maintenance of oral functions, comfort, appearance and health of the patient by the restoration
of natural teeth and/or the replacement of missing teeth and contiquous oral and maxillofacial
tissues with artificial substitutes.
A prosthesis - is the replacement of an absent part of the human body by some artificial part
such as an eye, a leg or a denture (McCracken).

Fixed – post and core, crown, bridge
 common appliances utilized in fixed prosthodontics
 terms related to components of fixed dentures

Removable – partial, complete dentures
 divisions in the Prosthodontic Field
 clasification of prosthesis

An introduction to fixed prosthodontics – terminology, range from the restoration of a
single tooth to the rehabilitation of the entire occlusion. Single tooth can be restored to full
function and improvement in cosmetic effect can be achieved. Missing teeth can be replaced
with fixed prostheses that will improve patient comfort and masticatory ability.
Different types of fixed prosthesis.
   A crown is a cemented extracoronal restoration that covers, or veneers the outer surface of
   the clinical crown. If it covers all of the clinical crown, the restoration is a full or complete
   veneer crown. If only portions the restoration is called a partial veneer crown.
      Intracoronal cast restorations are those that fit within the anatomic contours of the
   clinical crown of a tooth. Inlays – intracoronal single tooth restoration for proximo-
   occlusal or gingival lesions. When modified with an occlusal veneer the intracoronal
   restoration its called an onlay.
     The all ceramic laminate veneer or facial veneer is used in situations requiring an
   improved cosmetic appearance on an anterior tooth that is otherwise sound. It consist a thin
   layer of dental porcelain
     The fixed partial denture – bridge is a prosthetic appliance permanently attached to
   remaining teeth, which replaces one or more missing teeth.
     Terminology – abutment, retainer, pontic, connector,

Treatment planning for single-tooth restorations

Posts and cores ( dowel cores )
   - types, indications and contraindications, clinical procedure and technology
Crowns – types:
- Provisionals
- Permanents
partial, full
metal fused, metal ceramic crowns
cast gold, palladium
ceramic crowns (all ceramic)
telescopic
Indications for crown:
  Badly broken down teeth, primary trauma, tooth wear, Hypoplastic conditions, to alter the
occlusion, as part of another restoration, combined indications, multiple crowns,
Appearance
Function
Mechanical problems
Indications for anterior teeth: Caries and trauma, Non-vital teeth, Tooth wear, Hypoplastic
conditions, As part of another restorations
Indications for posterior teeth: Restoration of badly broken down teeth, Restoration of
endodontically treated teeth, As part of another restoration
The alternatives to anterior teeth.
The alternatives to posterior teeth.
Factors of choosing between cast metal or all ceramic.
Retention
Treatment planning for the replacement of missing teeth.

Replacement of missing teeth:
Removable partial denture

Conventional tooth-supported FPD (Bridges - routine fixed partial denture, cantilever fixed
partial denture)
Resin-bonded tooth supported FPD
Implant-supported FPD.
Bridges – types, indications and contraindications, general considerations in planning.
Abutment evaluation: Crown – Root Ratio (length), Root Configuration, Periodontal
Ligament Area
Biomechanical considerations.
Pontics and edentulous ridges.
Principles of tooth preparations
   - preparations for full veneer crowns
   - preparations for partial venner crowns
Provisional restorations. Prefabricated vs custom restorations. Direct vs indirect techniques
    Types
Goals for fabricating :
     1. Pulpal protection. 2.Positional stability. 3.Occlusal function. 4.Easily cleaned.
         5.Nonimpinging margins. 6.Strength and retention. 7.Esthetics.
     Clinical procedures
Impressions and working casts and dies. Clinical procedures. Materials and methods.
    Finish line exposure
        chemicomechanical (retraction cord)

Impressions
    Materials
Interocclusal records technique

Finishing and cementation of fixed prosthesis. Types of cements. Clinical procedures.

Cementation : Choice of cements Cementation technique

Postcementation

Special problems. Esthetic considerations in fixed prosthodontics.

Restoration of Endodontically Treated Teeth
Complications - iatrogenesis - Causes of failure and some solutions.

				
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