FIXED PARTIAL DENTURE CLASSIFICATION and TYPES of FPD 1.

SIMPLE FIXED BRIDGE Rigidly Fixed Bridge -permits no individual or independent movements of its parts and is also known as STATIONARY FIXED BRIDGE B. Semi Fixed Bridge -one which allows some individual or separate movements of some of its parts and is also known as LIMITED STATIONARY / BROKEN STRESS BRIDGE C. Cantilever Bridge -one which has one or more abutments at one end of the bridge while the other end is unsupported 2. COMPOUND FIXED BRIDGE -a combination fixed partial denture which employs two or more of the simple type in one restoration SUBCLASSIFICATION ACCORDING TO LOCATION Anterior or Labial Bridge Limited to incisor region Posterior or Buccal Bridge - from canine posteriorly to include premolars and molars Combination Antero-Posterior Bridge or Labio-Buccal bridge - includes anterior and posterior teeth COMPONENTS OF FIXED BRIDGE 1. Abutment It is the selected remaining tooth or teeth where a crown or a bridge is attached 2. Retainer It is the artificial crown or crowns used to attach the bridge to the abutment tooth/teeth. 3. Pontic artificial crown used to restore the missing tooth or teeth in the arch and may either be: all porcelain; porcelain fused to metal; plastic attached to metal; and all plastic 4. Connector Serves to connect retainer on one side to the other retainer on the other side of the bridge as well as unites all the other parts of the bridge FACTORS THAT INFLUENCE THE COMPONENTS SELECTION A. Abutment with vital pulp with normal amount of periodontal attachment capable of supporting additional forces to which it will be subjected as part of the FPD its preparation must be such that its retentive power shall be sufficient to resist the displacing forces to which it will be exposed B. Retainer must be so designed that it has sufficient strength margins prevent irritation of the soft tissues and recurrence of caries must be self-cleansing does not corrode or tarnish does not discolor it is aesthetic C. Pontics -restore the function of the tooth it replaces -meet the demands of esthetics and comfort -be biologically acceptable to the tissues

ensure its sanitation -prevent tissue inflammation of underlying residual ridge mucosa 4. Connector connector should be approximately 2mm. in size Connector should always pass through what would be normal contact area of teeth being replaced allows for creation of normal embrasures and interdental spaces Incisal/occlusal surface of connector should never have sharp edge, which presents cleavage point to porcelain Connector should be contoured interproximally to allow for equal porcelain coverage on adjoining teeth Anterior and Posterior Pontic Design Characteristics: All surfaces should be convex, smooth and properly finished The occlusal table must be in functional harmony with the occlusion of all the teeth The overall length of the buccal surface should be equal to that of the adjacent abutments/pontic The lingual contour should be in harmony with adjacent teeth or pontics Factors Influencing Fixed Bridge Design 1. Crown Length -teeth must have adequate occlusocervical crown length to achieve sufficient retention 2. Crown Form some teeth have tapered crown form which interferes with parallelism incisors possessing very thin highly translucent incisal edges 3. Degree of Mutilation size, number and location of carious lesions or restorations affect whether full or partial coverage retainers are indicated fractured or carious teeth not restorable should be removed thereby altering design and creating the need for a prosthesis 4. Root Length and Form roots with parallel sides and developmental depressions are better able to resist additional occlusal forces than are smooth-sided conical roots multirooted teeth generally provide greater stability than single-rooted teeth longer root has better retention than short root 5. Crown-Root Ratio 1:1.5 ratio has been generally acceptable whereas 1:1 ratio is considered minimal and requires consideration of other factors (ex. # of tth being replaced, tooth mobility, periodontal health) before it can be used as an abutment 6. Antes Law -periodontal ligament area/pericemental area of the abutment teeth should be equal or greater than the periodontal ligament area/pericemental area of the missing tooth/teeth 7. Periodontal Health absence of any form of periodontal disease such as bone resorption and gingival recession 8. Mobility

MILLER MOBILITY VALUE 1o mobility normal 2o mobility still acceptable provided that you must know the factor that cause the mobility (px age, presence of calcular deposit) and consider the # of tth being replaced 3o mobility can not be used as an abutment/for extraction 9. Span Length -distance between abutments affects the feasibility of placing fixed prosthesis ideal for 1-2 missing tth loss of 3 adjacent tth requires careful evaluation of other factors (crown-root ratio, root length and form, periodontal health, mobility) 10. Axial Alignment crowns of proposed abutments must be well aligned minor alterations in axial alignment (tipped/rotated) often necessitate the use of full coverage crowns to achieve retention or acceptable esthetics 11. Arch Form 12. Occlusion occlusal forces brought to bear on a prostheses are related to the ff: degree of muscular activity patients habit # of tth being replaced leverage on the bridge adequacy of bone support 13. Pulpal Health - abutment/s should not be sensitive to percussion or vitality testing abutments with poor pulpal health should undergo endodontic tx prior to tooth preparation 14. Alveolar Ridge Form not indicated for FPD if there is considerable bone loss 15. Age of Patient not indicated in older patient as well as adolescents when teeth are not fully erupted or with large pulps 16. Phonetics patients prefer FPD for good phonation (provides sufficient resistance to the flow of air to allow normal speech sounds to be produced) rather than RPD 17. Long-Term Abutment Prognosis take note of the oral hygiene -if there is question on the ability of the remaining supporting structure to accept additional occlusal forces, RPD is indicated tooth with sufficient loss of periodontal support and questionable prognosis may be best treated with an RPD rather than an FPD 18. Esthetics -prefer FPD because it resembles natural tooth -but RPD may be indicated when the use of a pontic produces large and unsightly proximal embrasures in a fixed prostheses. 19. Psychological Factors to most pxs an FPD feels more normal than an RPD and more quickly becomes an accepted part of the oral environment px feels more confident and looks good wearing FPD than RPD