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PDM_Clinical_IV_L3_En

Bridge restorations. Clinical stages. Temporary bridges impressions, Teeth

preparation, final impressions, adjustment, fixing (cementing), bridge removal

Fixed prosthodontics is the art and science of restoring damaged teeth with cast metal, metal-ceramic, or all-ceramic restorations, and of replacing missing teeth with fixed prostheses. The scope of fixed prosthodontic treatment can range from the restoration of a single tooth to the rehabilitation of the entire occlusion. Single teeth 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, maintain the health and integrity of the dental arches, and, in many instances, elevate the patient's self-image. The fixed partial denture is a prosthetic appliance, permanently attached to remaining teeth, which replaces one or more missing teeth. Although the term is preferred by prosthodontists, this type of restoration has long been called a bridge. "Bridge" is still in common usage.

Fixed prosthodontics includes restorations which are permanently cemented onto the

teeth. A fixed bridge (called also as fixed bridge prosthesis, bridge or fixed partial denture) is attached to remaining teeth to replace a missing tooth. Teeth serving as attachments for a fixed bridge are called abutments. The part of the fixed bridge which veneers the abutment tooth is called a retainer and the part which replaces a missing tooth is called a pontic. The connection between the retainers and pontic is referred to as connector.

Clinical Stages

First, the dentist have to make anaesthesia of the targeted area with anaesthetic, before reducing the adjacent abutment (teeth on either side of the space) to accommodate for the thickness of the crown. Next has to be made the impressions from which a metal framework, including the pontic, will be created. In the meantime, a temporary bridge has to be inserted to protect the teeth and gums. On the second visit to the dentist, the new permanent bridge will be fitted, checked and adjusted for any bite discrepancies. Finally, the new bridge will be cemented.

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The initial step in the dental bridge procedure is to assess the need for restorative dental treatment to replace missing teeth, and whether a dental bridge is the best option. Other restorative dental treatments that may be more appropriate in some cases include dental crowns and dental implants.

First Appointment: Teeth Preparation and Temporary Bridge Placement

The first step is to file the abutment teeth into an appropriate shape for the bridge to be

placed. Impressions of the shaped teeth are then made and sent to a dental laboratory for the

construction of the bridge. Patients may be fitted with a temporary bridge, which is typically

made out of filling material and functions to protect the shaped teeth from damage while the

permanent bridge is being constructed. This can later be removed when the permanent bridge is

ready to be placed in the mouth.

Second Appointment: Permanent Bridge Placement

The second appointment in the dental bridge procedure may take place as soon as the

unique appliance has been made and is ready to be placed. Once again, local anesthetic is usually

applied at the beginning of this appointment to increase patient comfort. Before the permanent

dental bridge can be placed, the temporary one should be removed and, if necessary, the

underlying teeth cleaned. Dental cement can then be used to fix the dental bridge in place on the

abutment teeth.

Follow Up

Aftercare and follow up is very important in the dental bridge procedure to ensure that

the patient knows what to expect and understands how to care for their new dental bridge. For

this reason, the dentist should take some time to explain the particulars of the dental bridge,

including the recommended oral care and when to seek dental advice.

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Diagnosis and Treatment Planning

Diagnosis is the determination of the nature of a diseased condition by careful

investigation of its symptoms and history.

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Temporary bridges impressions

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Teeth Preparation

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At the crown preparation appointment, the entire dentogingival complex is measured.

After the administration of local anesthesia, a periodontal probe is pushed through the sul-cus

until resistance is felt .The probe is then angled away from the clinical crown while the tip is still

touching the root surface and is pushed completely to the osseous crest . This process is called

bone sounding, and measurements are taken on the midfacial aspect of the tooth and at both

facioproximal line angles. If the probe is not angled correctly, there is a greater risk of the tip of

the probe skipping past the thin facial plate of bone, resulting in an inaccurate measurement.

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Final impressions

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Реферат върху препариране на зъби

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