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Crown & bridge

Crown & bridge

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Published by: api-19840404 on Nov 30, 2009
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03/18/2014

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Biomechnical considerations and
Configurations of FPDs
Abutment Evaluation
Why do we need to evaluate abutment when we plan for FPD /
RP D ?

The idea is it support the prostheses then it will carry the hole
load .
It's all retained load + the new load of the missing teeth . when
extract the teeth and we do replacement , the abutment teeth
carry the load of itself + the missing teeth . so we need to
evaluate the abutment before fabricate our prostheses .

Abutment evaluation mainly 2 :
1-
pulpal assessment of the abutment .

2- the supporting tissue :
\u2665 crown \u2013 root ratio .
\u2665 Root configuration .
\u2665 periodontal ligament area .

\u25a0 Pulpal assessment :

In fixed prosthodontic always vital teeth are preferable . it
could be nonvital , if it's non vital and it's endo treated it must
be properly evaluated . so either vital or proper endo treated
teeth , this endo treated teeth should not support more than 3
unit bridge . if we have upper right 6 pulpal treated and we
have missing 5 and 4 then the 6 is a pulpate abutment to carry
the load from the canine to 6 you can't use it to carry 4 unit
bridge . so endo treated teeth the guideline to use it when we
have 3 unit bridge OK . 3 unit bridge is the max extension of
the bridge to use it if have endo treated teeth as abutment . in
between either we have vital or endo treated teeth some time
you could have pulpal \u2013 capping . this pulp-capped teeth are

not not advised to be used as abutment it's contraindication . the reason is 8 % of sound abutment after preparation within 10 years they will be pulpal involved ( periapical infection , pulpitis , whatever ) this mean pulp-capped teeth have high risk \u2026 clear

Dr said if you don't understand come to me in clinic could be
do this procedure .
\u25a0 Crown \u2013 Root Ratio :

The definition is the amount of tooth structure above the
alveolar crest and the amount of structure below the alveolar
crest . this is the ratio part of the tooth which is outside the
alveolar crest and part of tooth which is inside . this is crown-
root ratio . ideally it's 2 : 3 when we use it for fixed
prosthodontic abutment ideally should be 2 to 3 .
In the exam if I said a tooth 40 mm length then the ideal
crown-root ratio is ?
16 mm is the best crown-root ratio .
Now the worst thing is to have 1 : 1 ratio , so when you have
50 % out of the alveolar crest , the resistant area of the tooth
to the load is less\u2026 right , and the resistant area of the
periodontal ligament area is less . the such scenario we could
accepted depending on the opposing occlusion . in another
word the natural teeth when bite the load per abutment about
70 \u2013 75 kg when you have opposing partial denture the load
is about 30 kg , when you have bridge the load about 26 kg
.so the opposing occlusion will determined the amount of
load will be retained by the bridge \u2026 clear
If I have 2 to 3 ratio this is the best scenario in all cases , but
if I have 1 to 1 then I looking for more acceptable occlusion
which is if I have opposing acrylic partial denture or CD or I
have bridge because the load will be less than natural teeth .

imagine I said in the exam you have crown-root ratio 1 : 1.5 ,
this is the best option for ?

\u25cb acrylic partial denture .
\u25cb cobalt partial denture .
\u25cb fixed partial denture .
\u25cb implant prostheses .
\u25cb natural teeth .

The more load from the crown-root ratio the less load you
need , the need load with acrylic prostheses more than cobalt
crom and the reason the cobalt crom supported by teeth .

You have to concentrate on two thing :
-
the ratio itself .
-
the opposing occlusion .
\u25a0 Root configuration :
-

Triangular root better than round ones .
The more irregular structure inside alveolar bone the better
the resistance because more irregularity it's more surface area
more periodontal ligament area more resistance .

-
Multi-rooted are better than single-rooted .
-

Widely spaced roots are preferable .
If you have upper 6 the root separate from each other better
from fused root because the surface area become bigger .

-

irregular roots are better .
that's mean curved lateral incisor better than typical lateral
incisor .

\u25a0 periodontal ligament area :
-

The greater the area is better .
As we said before the greater area you will have more
resistance , it's a relative values . 4ex : mine lower 6 have
surface area it's 25 mm and sharif has lower 6 it's 40 mm

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