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.